| John P Goeddertz, CRNA | |
|
1055 N Curtis Rd, Boise, ID 83706-1309 | |
| (208) 367-2163 | |
| Not Available |
| Full Name | John P Goeddertz |
|---|---|
| Gender | Male |
| Speciality | Certified Registered Nurse Anesthetist (crna) |
| Experience | 25 Years |
| Location | 1055 N Curtis Rd, Boise, Idaho |
| Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1659424125 | NPI | - | NPPES |
| 12462 | Medicaid | ND |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 367500000X | Nurse Anesthetist, Certified Registered | R26650 (North Dakota) | Secondary |
| 367500000X | Nurse Anesthetist, Certified Registered | RNA-694 (Idaho) | Primary |
| Facility Name | Location | Facility Type |
|---|---|---|
| Treasure Valley Hospital | Boise, ID | Hospital |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Anesthesiology Consultants Of Treasure Valley Pllc | 4981661196 | 26 |
| Entity Name | Boise Anesthesia, P A |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1487602298 PECOS PAC ID: 8426960642 Enrollment ID: O20031105000132 |
| Entity Name | St Alphonsus Professional Medical Services Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1386677524 PECOS PAC ID: 7214849751 Enrollment ID: O20040205001184 |
| Entity Name | Anesthesiology Consultants Of Treasure Valley Pllc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1124066063 PECOS PAC ID: 4981661196 Enrollment ID: O20041220000096 |
| Mailing Address | Practice Location Address |
|---|---|
| John P Goeddertz, CRNA Po Box 190930, Boise, ID 83719-0930 Ph: (208) 302-9342 | John P Goeddertz, CRNA 1055 N Curtis Rd, Boise, ID 83706-1309 Ph: (208) 367-2163 |
Allison Elisabeth May, Nurse Anesthetist - CR Medicare: Accepting Medicare Assignments Practice Location: 190 E Bannock St, Boise, ID 83712 Phone: 208-381-2222 | |
Mr. Douglas Neurath, Nurse Anesthetist - CR Medicare: Not Enrolled in Medicare Practice Location: 111 W State St, Boise, ID 83702 Phone: 208-336-0895 | |
Jordan B Wolff, CRNA Nurse Anesthetist - CR Medicare: Accepting Medicare Assignments Practice Location: 111 W State St, Boise, ID 83702 Phone: 208-336-0895 Fax: 208-338-1796 | |
Nathan S Call, CRNA Nurse Anesthetist - CR Medicare: Accepting Medicare Assignments Practice Location: 190 E Bannock St, Boise, ID 83712 Phone: 208-381-2222 | |
Ashton Hope Mieritz, CRNA Nurse Anesthetist - CR Medicare: Accepting Medicare Assignments Practice Location: 1055 N Curtis Rd, Boise, ID 83706 Phone: 208-367-2121 | |
Kenneth Clark Stratton Jr., CRNA Nurse Anesthetist - CR Medicare: Not Enrolled in Medicare Practice Location: 1055 N Curtis Rd, Boise, ID 83706 Phone: 208-367-2559 | |
Diana San Juan Shimko, CRNA Nurse Anesthetist - CR Medicare: Accepting Medicare Assignments Practice Location: 1055 N Curtis Rd, Boise, ID 83706 Phone: 208-367-6416 |