BLAKE D NIEDERHAUSER MD NPI 1578726683

NPI Information

  • NPI: 1578726683
  • Provider Name: BLAKE D NIEDERHAUSER, MD
  • Classification: Radiology - 2085R0202X
  • Specialization: Diagnostic Radiology
  • Entity Type: Individual
  • PECOS Registration: Yes
  • Address: 190 E BANNOCK ST
    BOISE, ID
    ZIP 83712
  • Phone: (208) 381-2094

Map and Directions

Get Directions

NPI Details

Blake D Niederhauser, MD is a diagnostic radiology radiology in Boise, ID with 18 years of experience. The provider is a radiologist who utilizes x-ray, radionuclides, ultrasound and electromagnetic radiation to diagnose and treat disease. Blake D Niederhauser, MD NPI is 1578726683. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

Education
Medical School: VANDERBILT UNIVERSITY SCHOOL OF MEDICINE
Graduation Year:2008

The provider's business location address is:

190 E BANNOCK ST
BOISE, ID
ZIP 83712-241
Phone: (208) 381-2094
Fax: (208) 381-1791

The NPI 1578726683 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.

  • Ct scan of chest without contrast (HCPCS:71250)
  • X-ray of chest, 1 view (HCPCS:71045)
  • Ct scan of chest with contrast (HCPCS:71260)
  • Ct scan of blood vessels of chest with contrast (HCPCS:71275)
  • X-ray of chest, 2 views (HCPCS:71046)
  • Low dose ct scan of chest for lung cancer screening (HCPCS:71271)
  • Ct scan of abdomen and pelvis with contrast (HCPCS:74177)
  • Nuclear medicine study from skull base to mid-thigh with ct scan (HCPCS:78815)
  • Ct scan of heart structure with contrast (HCPCS:75572)
  • Ct scan of blood vessels and grafts of heart with contrast (HCPCS:75574)
  • Mri scan of blood vessels of chest (HCPCS:71555)
  • Ct scan of blood vessels of abdomen and pelvis with contrast (HCPCS:74174)
  • Ct scan of heart with evaluation of blood vessel calcium (HCPCS:75571)
  • Mri scan of heart before and after contrast (HCPCS:75561)
  • Ct scan of abdomen and pelvis without contrast (HCPCS:74176)
  • X-ray of abdomen, 1 view (HCPCS:74018)
  • X-ray of ribs on side of body, minimum of 3 views (HCPCS:71101)
  • Ct scan head or brain without contrast (HCPCS:70450)

The enumeration date for this NPI number is 7/8/2008 and was last updated on 1/10/2018.

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 Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
12085R0202XRadiologyDiagnostic RadiologyM-12384IDAHOYes
22085R0202XRadiologyDiagnostic Radiology52314MINNESOTANo
32085R0202XRadiologyDiagnostic Radiology104451MINNESOTANo

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 Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1ENROLLEDMEDICAIDMINNESOTA
2ENROLLEDMEDICAIDIOWA

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: 11/21/2025

NPI Synchronization or Removal

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.