ROBERT CROUCH (DO) – Family Medicine Physician, NPI 1164801692

ROBERT CROUCH (DO) is a healthcare provider. based in Boise, Idaho. specializing in FAMILY PRACTICE. They hold the professional credentials DO. They hold a License No. MRO-1490 (ID). The NPI Number for ROBERT CROUCH (DO) is 1164801692

Main info

Male
11 Years Of Experience
Accepts Medicare Assignment
Name
ROBERT CROUCH (DO)
NPI
1164801692
Phone
(208) 514-2525
Address
121 E FORT ST
Enumeration Date
29 May 2015
Last Update Date
15 December 2023

Doctor Profile

Medical School Name
OTHER
Secondary Phone
2083542383
Graduation Year
2015 (11 years ago)
PAC ID
0749596880
Group Practice PAC ID
3870744956
Professional Enrollment ID
I20190107002924
Address ID
ID834225112DR120XXSTXX400
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience50
Completeness75
Years active:11State licenses:2Digital endpointsOther names

969 FAMILY PRACTICE in ID

Provider Addresses for ROBERT CROUCH (DO)

  • 121 E FORT ST

    BOISE, ID 837126322

    Phone: (208) 514-2525

    Fax: (208) 375-2217

    Type: Location

  • 777 N RAYMOND ST

    BOISE, ID 837049251

    Phone: (208) 514-2500

    Fax: (208) 375-2217

    Type: Mailing

  • 9850 W ST LUKES DR # 329

    NAMPA, ID 836877912

    Phone: (208) 514-2509

    Fax: (208) 375-2217

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2019-01-07

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20190107002924IFamily PracticeIDTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 83712)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 3870744956View full group profile
NameSpecialtyState
Physical Therapist In Private PracticeID
-ID
H O S P I T A L I S TAZ
Physician AssistantID
Physical Therapist In Private PracticeID
D E R M A T O L O G YID
-UT
Family PracticeID
Internal MedicineID
Physical Therapist In Private PracticeIL

Reviews

All reviews are moderated before publication. Reviews reflect users' opinions; we do not verify the accuracy of individual reviews.

No reviews yet. Be the first to share your experience — your opinion helps families compare providers.

Frequently asked questions

What federal number belongs to ROBERT CROUCH (DO)?
The federal identifier for ROBERT CROUCH (DO) is NPI 1164801692.
Is ROBERT CROUCH (DO) active in the national directory?
ROBERT CROUCH (DO)'s public NPI profile is in an active state.
Does ROBERT CROUCH (DO) list a primary specialty?
If you are matching referrals, note Family Medicine Physician for ROBERT CROUCH (DO). Clinical services aligned with this taxonomy classification.
Does ROBERT CROUCH (DO) practice in Idaho?
You will see Boise, Idaho on file for ROBERT CROUCH (DO) alongside any extra practice locations.
Is ROBERT CROUCH (DO) a real provider?
This page reflects official NPPES data for NPI 1164801692. Always confirm identity and privileges with the practice and licensing boards.

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