● Active Type 1 · Individual

Theodore Steven Roosevelt, M.D.

Internal Medicine·Boise, ID· NPI 1699754697 · Enumerated 2006 · 20 years on NPI

Roosevelt is 1 of 11 internal medicine providers in Boise and 1 of 33 in Idaho.

NPI age

20 years

Enumerated 2006-01-10

Primary specialty

Internal Medicine

Plus 1 subspecialty

Licensed in

1 state

Status

Active

No deactivations on record

Last NPPES update

2018-05-17

Source: monthly bulk 2026-05

Sole proprietor

Yes

Solo practice on file

How this provider compares

Across 33 active internal medicine providers in Idaho.

NPI age

20 years

↑ 2 yr above median (18 yr)

State licenses

1 state

12% of peers hold multiple states

Subspecialties

In the 48% of peers with subspecialties

NPI lifetime · 2006 → 2026

2006-01Enumerated in NPPES

2006 2026

Where they practice

Practice location

13909 W Wainwright Dr

Boise, ID 837131969

📞 2083892213fax 2083894659

Mailing address

13909 W Wainwright Dr

Boise, ID 837131969

📞 2083892213fax 2083894659

Specialties

Allopathic & Osteopathic Physicians › Internal Medicine

Internal Medicine Primary

An internist who concentrates on disorders of the internal (endocrine) glands such as the thyroid and adrenal glands. This specialist also deals with disorders such as diabetes, metabolic and nutritional disorders, obesity, pituitary...

ID license #M6142 taxonomy 207RE0101X
Internal Medicine

A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer,...

ID license #M6142 taxonomy 207R00000X

Identifiers

Type	Value	Notes
05 (ID)	002712100

Practice context

Part of a multi-provider practice. 3 other active providers share this practice address in NPPES.

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How to verify this provider

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.
Confirm payer enrollment if billing.NPI presence does not guarantee active enrollment with Medicare, Medicaid, or commercial payers.