Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of October 4, 2026.
NPIDirectory

Mark E Kieckbusch, MD

Individual provider Anatomic Pathology & Clinical Pathology Physician · NPI 1215981410

Mark E Kieckbusch, MD is an Anatomic Pathology & Clinical Pathology Physician in Boise, Idaho. Licensed in Idaho. Registered with an NPI since 2006.

Licensed in
ID
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

190 E Bannock St
Boise, ID 83712-6241 Not confirmed with CMS for 18 years — call before visiting
Phone: (208) 381-2367
Fax: (208) 381-4762
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Anatomic Pathology & Clinical Pathology Physician (primary) Taxonomy 207ZP0102X · Licence M6070 (ID)
Hematology (Pathology) Physician Taxonomy 207ZH0000X · Licence M6070 (ID)

Record details

NPI number1215981410
Entity typeIndividual (Type 1)
GenderMale
Credentials MD
Sole proprietorNo
NPI enumeratedMay 20, 2006
Last updated in NPPESDecember 11, 2007

Medicare patients and services, 2024

From the CMS Medicare Physician & Other Practitioners file for calendar year 2024. It counts Original Medicare patients only, so a practice that mostly sees Medicare Advantage or privately insured patients looks smaller here than it is.

Medicare patients213
Services billed 728 a service is one billed item, such as a visit, a test or a procedure
Average patient age72

Dollar amounts are not shown. What Medicare pays a practice is gross billings, before staff, premises and tax and including the cost of any drugs it administers, so it is not what a clinician earns.

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