NPI age
19 years
Enumerated 2006-11-13
● Active
Type 1 · Individual
Mary K Derlacki, FNP
Derlacki is 1 of 11 internal medicine providers in Boise and 1 of 38 in Idaho.
Primary specialty
Internal Medicine
Plus 1 subspecialty
Licensed in
OR, ID
2 states
Status
Active
No deactivations on record
Last NPPES update
2024-10-17
Source: monthly bulk 2026-05
Sole proprietor
No
May be part of a larger org
How this provider compares
Across 38 active internal medicine providers in Idaho.
NPI age
19 years
≈ at median (19 yr)
State licenses
2 states
Top 60% — 39% of peers are multi-state
Subspecialties
1
In the 44% of peers with subspecialties
NPI lifetime · 2006 → 2026
2006-11Enumerated in NPPES
2006
2026
Where they practice
Practice location
2800 W Overland Rd
Boise, ID 837053038
Mailing address
1707 N 19th St
Boise, ID 837020706
Specialties
-
Internal Medicine PrimaryAn internist who treats diseases of joints, muscle, bones and tendons. This specialist diagnoses and treats arthritis, back pain, muscle strains, common athletic injuries and "collagen" diseases.
-
Nurse PractitionerDefinition to come...
Identifiers
| Type | Value | Notes |
|---|---|---|
| 05 (OR) | 005785 |
Multi-state credentialing: Licensed in 2 states. Useful context for credentialers building cross-state provider networks.
Practice context
Part of a multi-provider practice. 3 other active providers share this practice address in NPPES.
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- Confirm the NPI on NPPES.The CMS registry is the system of record. Open NPPES →
- Check the state license is currently active.State licensing boards publish current status; NPPES does not.
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