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

Samuel Douglass, DO

Individual provider Diagnostic Radiology Physician · NPI 1063801678

Samuel Douglass, DO practises Diagnostic Radiology in Boise, Idaho. Graduated from Rocky Vista University College of Osteopathic Med in 2015, 11 years ago. Practices with Gem State Radiology LLP, a 42-clinician group, works from 4 locations and accepts Medicare assignment. Licensed in Idaho, Nebraska, Oregon and Washington.

Years since qualifying
11
Trained at
Rocky Vista University College of Osteopathic Med
Licensed in
ID, NE, OR, WA
In the registry since
2015
Specialties on file
4
What do these letters mean?
DO — Doctor of Osteopathic Medicine
A fully licensed physician, trained like an MD with additional musculoskeletal training. Equivalent practice rights in all 50 states.

See every abbreviation used in this directory →

Practice location Address checks out

1055 N Curtis Rd
Boise, ID 83706-1309
Phone: (208) 367-2121
Fax: (706) 596-6720
Show map & directions

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

Additional practice locations (3)

  • 300 W Hospital Rd, Fort Gordon, GA 30905-5741 — (706) 787-2175
  • 9040 Fitzsimmons Dr, Joint Base Lewis McChord, WA 98431-1000 — (253) 968-0369
  • 1304 Fawcett Ave Ste 100, Tacoma, WA 98402-1900 — (253) 761-4200

Specialties & licences

Diagnostic Radiology Physician (primary) Taxonomy 2085R0202X · Licence OC-0433 (ID)
Diagnostic Radiology Physician Taxonomy 2085R0202X · Licence OP61322937 (WA)
Diagnostic Radiology Physician Taxonomy 2085R0202X · Licence DO219310 (OR)
Diagnostic Radiology Physician Taxonomy 2085R0202X · Licence 1539 (NE)

Record details

NPI number1063801678
Entity typeIndividual (Type 1)
GenderMale
Credentials DO
Sole proprietorNo
NPI enumeratedJanuary 20, 2015
Last updated in NPPESApril 18, 2025
Certification dateApril 18, 2025

Medicare enrollment

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

Medicare specialtyDIAGNOSTIC RADIOLOGY
Medical schoolROCKY VISTA UNIVERSITY COLLEGE OF OSTEOPATHIC MED
Graduated 2015 (11 years in practice)
Group practice Gem State Radiology Llp — 42 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations3 on file with Medicare

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 patients431
Services billed 833 a service is one billed item, such as a visit, a test or a procedure
Average patient age74

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.

Practises at

Facilities the CMS Facility Affiliation file lists for this clinician.

Colleagues at Gem State Radiology LLP

Clinicians the CMS Doctors & Clinicians file lists under the same group practice. CMS counts 42 clinicians in the practice; 12 are shown here.

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