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MARK DY-LIACCO M.D. NPI 1366488850


NPI Information

NPI: 1366488850
Provider Name: MARK DY-LIACCO, M.D.
Classification: Surgery - 208600000X
Entity Type: Individual

PECOS Registration: Yes

Address:
100 E IDAHO ST STE 301
BOISE, ID
ZIP 83712
Phone: (208) 381-9250
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Mark Dy-liacco, M.D. is a surgery in Boise, ID. The provider is a general surgeon has expertise related to the diagnosis - preoperative, operative and postoperative management - and management of complications of surgical conditions in the following areas: alimentary tract; abdomen; breast, skin and soft tissue; endocrine system; head and neck surgery; pediatric surgery; surgical critical care; surgical oncology; trauma and burns; and vascular surgery. General surgeons increasingly provide care through the use of minimally invasive and endoscopic techniques. Many general surgeons also possess expertise in transplantation surgery, plastic surgery and cardiothoracic surgery. Mark Dy-liacco, M.D. NPI is 1366488850. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

100 E IDAHO ST STE 301
BOISE, ID
ZIP 83712-269
Phone: (208) 381-9250

The NPI 1366488850 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 6/21/2006 and was last updated on 7/7/2023.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1204F00000XTransplant Surgery306134NEW YORKNo
2208600000XSurgery036-100492ILLINOISNo
3208600000XSurgery0010-09358NORTH CAROLINANo
42086S0102XSurgerySurgical Critical Care036-100492ILLINOISNo
52086S0102XSurgerySurgical Critical Care306134NEW YORKNo
6208600000XSurgeryM-16367IDAHOYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
11366488850MEDICAIDNORTH CAROLINA
2NCW874AOTHERNORTH CAROLINAMEDICARE
319PD0OTHERNORTH CAROLINABCBS OF NC

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.