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THEODORE STEVEN ROOSEVELT M.D. NPI 1699754697


NPI Information

NPI: 1699754697
Provider Name: THEODORE STEVEN ROOSEVELT, M.D.
Classification: Internal Medicine - 207RE0101X
Entity Type: Individual

Specialization: Endocrinology, Diabetes & Metabolism

PECOS Registration: Yes

Address:
13909 W WAINWRIGHT DR
BOISE, ID
ZIP 83713
Phone: (208) 389-2213
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Theodore Steven Roosevelt, M.D. is an endocrinology and diabetes and metabolism internal medicine in Boise, ID with 50 years of experience. The provider is an 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 diseases and menstrual and sexual problems. Theodore Steven Roosevelt, M.D. NPI is 1699754697. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

Education
Medical School: UNIVERSITY OF UTAH SCHOOL OF MEDICINE
Graduation Year:1974

The provider's business location address is:

13909 W WAINWRIGHT DR
BOISE, ID
ZIP 83713-969
Phone: (208) 389-2213
Fax: (208) 389-4659

The NPI 1699754697 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 following top HCPCS codes were publicly reported for this provider under the Medicare program for the year 2016. The reported codes are based on the top codes for each available Medicare specialty, excluding evaluation and management codes.

  • Ambulatory continuous glucose (sugar) including interpretation and report for a minimum of 72 hours (HCPCS:95251)

The enumeration date for this NPI number is 1/10/2006 and was last updated on 5/17/2018.


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
1207R00000XInternal MedicineM6142IDAHONo
2207RE0101XInternal MedicineEndocrinology, Diabetes & MetabolismM6142IDAHOYes

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
1002712100MEDICAIDIDAHO

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.