NPI age
18 years
Enumerated 2008-01-07
● Active Type 2 · Organization
Idaho Diabetes And Endocrine Associates, PA
Idaho Diabetes And Endocrine Associates, PA is 1 of 33 internal medicine organizations in Idaho.
Primary specialty
Internal Medicine
Plus 1 secondary
Practice locations
1
0 secondary on file
Status
Active
No deactivations on record
Authorized official
Roosevelt
President
Last NPPES update
2022-05-18
Source: monthly bulk 2026-05
How this organization compares
Across 33 active internal medicine providers in Idaho.
NPI age
18 years
≈ at median (18 yr)
Practice locations
1
0 secondary on file
Subspecialties
1
In the 48% of peers with subspecialties
NPI lifetime · 2008 → 2026
2008-01Enumerated in NPPES
2008
2026
Where they practice
Primary practice location
13909 W. Wainwright Drive
Boise, ID 837131969
Mailing address
13909 W. Wainwright Drive
Boise, ID 837131969
Authorized official
Theodore S Roosevelt, MD, PHD, JD
President
📞 2083892213
Specialties
-
Internal Medicine PrimaryAn 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...
-
SpecialistAn individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree.
Identifiers
| Type | Value | Notes |
|---|---|---|
| 01 (ID) | 000010035381 | REGENCE BLUE SHIELD OF ID |
| 05 (ID) | 002712100 | |
| 01 (ID) | 77021 | BLUE CROSS OF IDAHO |
Other names on file (1)
Doing-business-as, former, and alternate names recorded by NPPES.
-
Idaho Diabetes & Endocrine Associates, PA
Practice context
Single-site organization. Only one practice location on file.
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