PHATAMA PADAVANIJA (MD) – Medical Oncology Physician, NPI 1679527717

PHATAMA PADAVANIJA (MD) is a healthcare provider. based in Boise, Idaho. specializing in MEDICAL ONCOLOGY. They hold the professional credentials MD. They hold a License No. 17531 (AL). The NPI Number for PHATAMA PADAVANIJA (MD) is 1679527717

Main info

Female
36 Years Of Experience
Accepts Medicare Assignment
Name
PHATAMA PADAVANIJA (MD)
NPI
1679527717
Phone
(208) 381-2222
Address
190 E BANNOCK ST
Enumeration Date
22 May 2006
Last Update Date
4 August 2014

Doctor Profile

Medical School Name
UNIVERSITY OF SOUTH ALABAMA COLLEGE OF MEDICINE
Secondary Phone
2088141600
Graduation Year
1990 (36 years ago)
PAC ID
2567417215
Group Practice PAC ID
4981878402
Professional Enrollment ID
I20110406000816
Address ID
ID833015860TW725XXWXXX500
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience68
Completeness75
Years active:20State licenses:2Digital endpointsOther names

41 MEDICAL ONCOLOGY in ID

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Provider Addresses for PHATAMA PADAVANIJA (MD)

  • St. Luke's Boise Medical Center, 190, East Bannock Street, Downtown, Boise, Ada County, Idaho, 83712, United States

    BOISE, ID 837126241

    Phone: (208) 381-2222

    Type: Mailing

  • 725, Pole Line Road West, Twin Falls, Twin Falls County, Idaho, 83301, United States

    TWIN FALLS, ID 833015800

    Phone: (208) 814-1600

    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: 2011-04-06

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
I20110406000816IMedical OncologyIDTBD

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
99214Established patient office or other outpatient visit, 30-39 minutes484163$0
99213Established patient office or other outpatient visit, 20-29 minutes187143$0
99215Established patient office or other outpatient visit, 40-54 minutes9361$0
99205New patient office or other outpatient visit, 60-74 minutes4848$0
99204New patient office or other outpatient visit, 45-59 minutes4141$0
View full utilization report →

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: 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

Does PHATAMA PADAVANIJA (MD) share an NPI with anyone else?
NPI numbers are unique to each provider or organization — PHATAMA PADAVANIJA (MD) uses 1679527717.
Can I rely on PHATAMA PADAVANIJA (MD) being an active provider?
As of the registry snapshot, PHATAMA PADAVANIJA (MD) is marked active.
What is PHATAMA PADAVANIJA (MD)'s specialty?
The listing groups PHATAMA PADAVANIJA (MD) with Medical Oncology Physician. Clinical services aligned with this taxonomy classification.
Where is PHATAMA PADAVANIJA (MD) based?
PHATAMA PADAVANIJA (MD) is tied to Boise, Idaho in the data we show; additional addresses may exist on the full record.
What does 'Individual Provider' mean on this profile?
Entity type tells you whether the number belongs to a person or an organization.

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