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Deactivated NPI 1740584366 Deactivated / Inactive NPI Male Practitioner

Dr. Lester Phil Nyborg , MD

General Practice • Boise, ID

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Notice of NPI Deactivation & Inactive Practice Status

According to official public domain records published by CMS (Centers for Medicare & Medicaid Services) in the National Provider Identifier (NPPES) Registry, Dr. Lester Nyborg has officially deactivated this NPI record and ceased active healthcare practice.

Registration / Start Date December 23, 2010
NPI Deactivation Date June 15, 2017
Total Practice Duration ~7 Years of Practice (2010 – 2017)

Professional Overview & Biography Verified Profile Summary

Dr. Lester Nyborg, MD was a registered General Practice practicing in Boise, ID. Throughout an active medical career spanning 7 years, Dr. Nyborg provided care at the practice location at 550 W. FORT ST. until profile deactivation on 2017-06-15.

Practice Location & Contact Primary Location

Practice Address

550 W. Fort St.
(Federal Court House) Boise Meps

Boise, ID 837240101

Telephone 2083341450

Specialty Benchmarks & Practice Insights

Comparative analytics for General Practice in Boise, ID

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 46.5 Yrs
State Avg: 23.6 Yrs
Regional Practice Density
8 Specialists

Practicing in Boise, ID (37 Statewide)

Telehealth Adoption Rate
12.5% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Medical Specialties & State Licenses

General Practice Primary Specialty

NUCC Taxonomy Code: 208D00000X

State License ID M-3478

A physician who specializes in the general practice of diagnosing, treating, and managing patients with a variety of illnesses and conditions.

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

7 Historical Events
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NPI Profile Deactivated June 15, 2017

Record deactivated on June 15, 2017

NPI Profile Active December 23, 2010

NPI status registered as active in NPPES database

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Updated Practice Location December 23, 2010

Registered at 550 W. FORT ST., (FEDERAL COURT HOUSE) BOISE MEPS, BOISE, ID 837240101 (Tel: 2083341450)

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Updated Business Mailing Address December 23, 2010

Registered at 550 W. FORT ST., BOISE MEPS, BOISE, ID 837240101 (Tel: 2083341450)

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Provider Name / Credentials Updated December 23, 2010

Recorded as LESTER NYBORG, MD

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Medical Taxonomy / Specialty Registered (Primary Specialty) December 23, 2010

General Practice (License #M-3478 in ID)

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Initial NPI Registration & Enumeration December 23, 2010

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1740584366
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: December 23, 2010
Last Update: December 23, 2010
Deactivation Date: June 15, 2017

Mailing Address

550 W. Fort St., Boise Meps

Boise, ID 837240101

Phone: 2083341450

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.