ETHAN FEUERBORN (D.O.) – Internal Medicine Physician, NPI 1629418280

ETHAN FEUERBORN (D.O.) is a healthcare provider. based in Boise, Idaho. specializing in INTERNAL MEDICINE. They hold the professional credentials D.O.. They hold a License No. O-1045 (ID). The NPI Number for ETHAN FEUERBORN (D.O.) is 1629418280

Main info

Male
13 Years Of Experience
Accepts Medicare Assignment
Name
ETHAN FEUERBORN (D.O.)
NPI
1629418280
Phone
Not provided
Address
500 W FORT ST
Enumeration Date
27 June 2013
Last Update Date
5 August 2025

Doctor Profile

Medical School Name
AT STILL UNIVERSITY OF HEALTH SCIENCES, COLLEGE OF OSTEO MED, KIRKSVILLE
Secondary Phone
2083819384
Graduation Year
2013 (13 years ago)
PAC ID
2264750066
Group Practice PAC ID
4981878402
Professional Enrollment ID
I20170728003034
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience53
Completeness85
Years active:12State licenses:1Digital endpointsOther names

560 INTERNAL MEDICINE in ID

Provider Addresses for ETHAN FEUERBORN (D.O.)

  • 500 W FORT ST

    #111R

    BOISE, ID 837024501

    Phone:

    Type: Mailing

  • 7272 W POTOMAC DR

    BOISE, ID 837049149

    Phone: (088) 842-9222

    Fax: (208) 884-2923

    Type: Mailing

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: 2024-07-17

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking 2 Medicare enrollment records; no due dates published yet.

Enrollment records

2

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
I20170728003034IInternal MedicineIDTBD
I20240717004091IInternal MedicineNMTBD

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.

Top Medicare procedures (2023) · refreshed 2026-05-27

HCPCSDescriptionServicesBeneficiariesMedicare allowed
99223Initial hospital care with moderate level of medical decision making, if using time, at least 75 minutes9794$0
99222Initial hospital care with straightforward or low-level medical decision making, if using time, at least 55 minutes1616$0
99283Emergency department visit with low level of medical decision making1111$0
View full utilization report →

Insurance plans in this area (ZIP 83702)

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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: 4981878402View full group profile
NameSpecialtyState
Family PracticeME
Internal MedicineID
Family PracticeID
-TX
-OR
Hand SurgeryID
-ID
Nurse PractitionerID
Physician AssistantID
General SurgeryID

Reviews

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Frequently asked questions

What is the standard ID for ETHAN FEUERBORN (D.O.) in the U.S.?
In the U.S., ETHAN FEUERBORN (D.O.) is identified by NPI 1629418280.
Is ETHAN FEUERBORN (D.O.) currently accepting referrals based on NPI status?
Registry metadata lists ETHAN FEUERBORN (D.O.) as active.
Which specialty label fits ETHAN FEUERBORN (D.O.)?
NPPES ties ETHAN FEUERBORN (D.O.) to Internal Medicine Physician in the taxonomy section. Clinical services aligned with this taxonomy classification.
What geographic area is tied to ETHAN FEUERBORN (D.O.)?
ETHAN FEUERBORN (D.O.) is associated with Boise, Idaho in the same public data insurers reference.
Can I export ETHAN FEUERBORN (D.O.)'s record?
You can download the official NPPES record; we summarize key fields for readability.

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