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

Kimiknu Mentore, MD

Individual provider Student in an Organized Health Care Education/Training Program · NPI 1184128480

Kimiknu Mentore, MD is an Infectious Disease in Boise, Idaho. Qualified in 2018, 8 years ago. Practices with Saint Alphonsus Regional Medical Center Inc, a 673-clinician group, works from 2 locations, accepts Medicare assignment and offers telehealth. Licensed in Idaho and New Mexico.

Years since qualifying
8
Licensed in
ID, NM
In the registry since
2018
Specialties on file
4
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

5966 W Curtisian Ave
Boise, ID 83704-8801
Phone: (208) 302-5450
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 1 University Of New Mexico, Albuquerque, NM 87131 — (505) 272-4461

Specialties & licences

Internal Medicine Physician (primary) Taxonomy 207R00000X · Licence 2771058 (ID)
Student in an Organized Health Care Education/Training Program Taxonomy 390200000X (NM)
Infectious Disease Physician Taxonomy 207RI0200X · Licence MD2024-0242 (NM)
Student in an Organized Health Care Education/Training Program Taxonomy 390200000X

Record details

NPI number1184128480
Entity typeIndividual (Type 1)
GenderFemale
Credentials MD
Sole proprietorNo
NPI enumeratedMarch 21, 2018
Last updated in NPPESOctober 9, 2025
Certification dateOctober 9, 2025
Mailing addressPo Box 190930, Boise, ID 83719-0930

Medicare enrollment

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

Medicare specialtyINFECTIOUS DISEASE
Medical schoolOTHER
Graduated 2018 (8 years in practice)
Group practice Saint Alphonsus Regional Medical Center Inc — 673 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
TelehealthOffers telehealth services
Practice locations6 on file with Medicare

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