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

Dr. Ryan Lewis Van de Graaff, MD

Individual provider Otolaryngology Physician · NPI 1619067436

Dr. Ryan Lewis Van de Graaff, MD is an Otolaryngology in Boise, Idaho. Graduated from University of Utah School of Medicine in 1998, 28 years ago. Practices with Southwest Idaho Ear Nose and Throat, a 15-clinician group, accepts Medicare assignment and offers telehealth. Licensed in Idaho and Nebraska.

Years since qualifying
28
Trained at
University of Utah School of Medicine
Licensed in
ID, NE
In the registry since
2006
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

900 N Liberty St Ste 400
Boise, ID 83704
Phone: (208) 367-3320
Fax: (208) 367-7474
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Otolaryngology Physician (primary) Taxonomy 207Y00000X · Licence M-10288 (ID)
Otolaryngology Physician Taxonomy 207Y00000X · Licence 22476 (NE)

Record details

NPI number1619067436
Entity typeIndividual (Type 1)
GenderMale
Credentials MD
Sole proprietorNo
NPI enumeratedOctober 13, 2006
Last updated in NPPESJune 1, 2010

Medicare enrollment

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

Medicare specialtyOTOLARYNGOLOGY
Medical schoolUNIVERSITY OF UTAH SCHOOL OF MEDICINE
Graduated 1998 (28 years in practice)
Group practice Southwest Idaho Ear Nose And Throat — 15 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
TelehealthOffers telehealth services

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