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

Nicholas Blickenstaff, MD, MS

Individual provider Dermatology Physician · NPI 1437544582

Nicholas Blickenstaff, MD, MS is a Dermatology in Boise, Idaho. Graduated from University of Utah School of Medicine in 2019, 7 years ago. Practices with Ada Dermatology P A, a 5-clinician group and works from 2 locations. Licensed in Idaho and Illinois.

Years since qualifying
7
Trained at
University of Utah School of Medicine
Licensed in
ID, IL
In the registry since
2015
Specialties on file
2
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.
MS — Master of Science
A graduate science degree.

See every abbreviation used in this directory →

Practice location Address checks out

6454 W Emerald St
Boise, ID 83704-8734
Phone: (208) 377-0820
Fax: (208) 375-8046
Show map & directions

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

Additional practice locations (1)

  • 13176 W Persimmon Ln, Boise, ID 83713-5063 — (208) 939-8640

Specialties & licences

Dermatology Physician (primary) Taxonomy 207N00000X · Licence M15699 (ID)
Dermatology Physician Taxonomy 207N00000X · Licence 036.150002 (IL)

Record details

NPI number1437544582
Entity typeIndividual (Type 1)
GenderMale
Credentials MD , MS
Sole proprietorYes
NPI enumeratedApril 4, 2015
Last updated in NPPESApril 25, 2022
Certification dateApril 25, 2022

Medicare enrollment

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

Medicare specialtyDERMATOLOGY
Medical schoolUNIVERSITY OF UTAH SCHOOL OF MEDICINE
Graduated 2019 (7 years in practice)
Group practice Ada Dermatology P A — 5 clinicians
Accepts Medicare assignment Not indicated

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