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

Dr. Geoffry De Gennaro Jr., MD

Individual provider Diagnostic Radiology Physician · NPI 1336554740

Dr. Geoffry De Gennaro Jr., MD is a Diagnostic Radiology in Boise, Idaho. Graduated from Medical College of Wisconsin in 2014, 12 years ago. Practices with Weiser Valley Hospital District, a 60-clinician group and accepts Medicare assignment. Licensed in Idaho and Michigan.

Years since qualifying
12
Trained at
Medical College of Wisconsin
Licensed in
ID, MI
In the registry since
2014
Specialties on file
2
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.

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Practice location Address checks out

190 E Bannock St
Boise, ID 83712-6241
Phone: (208) 381-2094
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Diagnostic Radiology Physician (primary) Taxonomy 2085R0202X · Licence M-15099 (ID)
Diagnostic Radiology Physician Taxonomy 2085R0202X · Licence 4301105483 (MI)

Record details

NPI number1336554740
Entity typeIndividual (Type 1)
GenderMale
Credentials MD
Sole proprietorNo
NPI enumeratedJune 24, 2014
Last updated in NPPESJuly 23, 2020
Certification dateJuly 23, 2020

Medicare enrollment

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

Medicare specialtyDIAGNOSTIC RADIOLOGY
Medical schoolMEDICAL COLLEGE OF WISCONSIN
Graduated 2014 (12 years in practice)
Group practice Weiser Valley Hospital District — 60 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations3 on file with Medicare

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