| Sage Healthcare Pllc | |
|
413 N Allumbaugh St Ste 101 Boise ID 83704-9212 | |
| (208) 323-1125 | |
| (208) 323-9604 |
| Full Name | Sage Healthcare Pllc |
|---|---|
| Speciality | Family Medicine |
| Location | 413 N Allumbaugh St, Boise, Idaho |
| Authorized Official Name and Position | Cheri Peterson (CREDENTIALER) |
| Authorized Official Contact | 2089545594 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Sage Healthcare Pllc 413 N Allumbaugh St Ste 101 Boise ID 83704-9212 Ph: (208) 323-1125 | Sage Healthcare Pllc 413 N Allumbaugh St Ste 101 Boise ID 83704-9212 Ph: (208) 323-1125 |
| NPI Number | 1891820767 |
|---|---|
| Provider Enumeration Date | 02/22/2007 |
| Last Update Date | 04/20/2021 |
| Medicare PECOS PAC ID | 7810974904 |
|---|---|
| Medicare Enrollment ID | O20040709001202 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1891820767 | NPI | - | NPPES |
| 807468900 | Medicaid | ID |
| Provider Name | Janet G Graf |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1467556688 PECOS PAC ID: 5890738587 Enrollment ID: I20050603000320 |
| Provider Name | Michael A Kaylor |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1104878610 PECOS PAC ID: 1355345216 Enrollment ID: I20060907000080 |
| Provider Name | Michael B Loegering |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1821038704 PECOS PAC ID: 3476559477 Enrollment ID: I20061016000164 |
| Provider Name | Stacia S Munn |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1477586162 PECOS PAC ID: 8325191281 Enrollment ID: I20090725000040 |
| Provider Name | Christopher D Streeter |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1811968217 PECOS PAC ID: 1456514736 Enrollment ID: I20130927000642 |
| Provider Name | Tara Sibert Whitaker |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1134416647 PECOS PAC ID: 1052558814 Enrollment ID: I20140804000488 |
| Provider Name | Michelle T Cullinan |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1619487345 PECOS PAC ID: 0446511596 Enrollment ID: I20180306000964 |
| Provider Name | Theresa Michele Pecsek |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1588248801 PECOS PAC ID: 9133524689 Enrollment ID: I20210820001463 |
| Provider Name | Kim Knudson |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1457885527 PECOS PAC ID: 2668745514 Enrollment ID: I20220804001330 |
| Provider Name | Heidi Paine |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1457033870 PECOS PAC ID: 4183070246 Enrollment ID: I20231025001928 |
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