NPI age
19 years
Enumerated 2006-10-19
● Active Type 2 · Organization
Ada Dermatology, P.A.
Ada Dermatology, P.A. is 1 of 2 dermatology organizations in Idaho.
Primary specialty
Dermatology
Practice locations
1
0 secondary on file
Status
Active
No deactivations on record
Authorized official
Blickenstaff
President
Last NPPES update
2012-01-30
Source: monthly bulk 2026-05
How this organization compares
Across 2 active dermatology providers in Idaho.
NPI age
19 years
≈ at median (19 yr)
Practice locations
1
0 secondary on file
Subspecialties
0
NPI lifetime · 2006 → 2026
2006-10Enumerated in NPPES
2006
2026
Where they practice
Primary practice location
6454 W Emerald Street
Boise, ID 837048734
Mailing address
6454 W Emerald Street
Boise, ID 837048734
Authorized official
Richard Dale Blickenstaff, M.D.
President
📞 2083770820
Individual providers at this organization
1 individual provider on file at this primary practice address.
- Richard Blickenstaff, M.D. Dermatology NPI 1265514582
Specialties
-
Dermatology PrimaryProcedural Dermatology, a subspecialty of Dermatology, encompassing a wide variety of surgical procedures and methods to remove or modify skin tissue for health or cosmetic benefit. These methods include scalpel surgery, laser surgery,...
Identifiers
| Type | Value | Notes |
|---|---|---|
| 05 (ID) | 002639100 |
Practice context
Multi-provider organization. 1 individual provider on file at this primary address.
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- Confirm the NPI on NPPES.The CMS registry is the system of record. Open NPPES →
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