Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Dr. Daniel Jackson Dickman, DO

Individual provider Diagnostic Radiology Physician · NPI 1902256548

Dr. Daniel Jackson Dickman, DO is a Diagnostic Radiology in Boise, Idaho. Qualified in 2016, 10 years ago. Practices with Boise Radiology Group PLLC, a 63-clinician group and accepts Medicare assignment. Licensed in Arizona, Idaho and New Mexico.

Years since qualifying
10
Licensed in
AZ, ID, NM
In the registry since
2016
Specialties on file
4
What do these letters mean?
DO — Doctor of Osteopathic Medicine
A fully licensed physician, trained like an MD with additional musculoskeletal training. Equivalent practice rights in all 50 states.

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Practice location Address checks out

190 E Bannock St
Boise, ID 83712-6241
Phone: (208) 381-2809
Fax: (208) 381-1791
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Diagnostic Radiology Physician (primary) Taxonomy 2085R0202X · Licence O-1709 (ID)
Diagnostic Radiology Physician Taxonomy 2085R0202X · Licence 009081 (AZ)
Surgery Physician Taxonomy 208600000X · Licence R2701 (AZ)
Student in an Organized Health Care Education/Training Program Taxonomy 390200000X (NM)

Record details

NPI number1902256548
Entity typeIndividual (Type 1)
GenderMale
Credentials DO
Sole proprietorNo
NPI enumeratedJune 14, 2016
Last updated in NPPESJuly 8, 2022
Certification dateJuly 8, 2022
Mailing address2894 W Neff St, Boise, ID 83703-5404

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyDIAGNOSTIC RADIOLOGY
Medical schoolOTHER
Graduated 2016 (10 years in practice)
Group practice Boise Radiology Group Pllc — 63 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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