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

Tin Vuong

Individual provider Sports Medicine (Family Medicine) Physician · NPI 1417223892

Tin Vuong is a Sports Medicine in Boise, Idaho. Graduated from At Still Un of Hlth Sciences, Col of Osteo Med, Mesa in 2012, 14 years ago. Practices with St Lukes Clinic-Treasure Valley LLC, a 1,150-clinician group, works from 3 locations and accepts Medicare assignment. Licensed in Idaho.

Years since qualifying
14
Trained at
At Still Un of Hlth Sciences, Col of Osteo Med, Mesa
Licensed in
ID
In the registry since
2012
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Practice location Address checks out

703 S Americana Blvd Ste 120
Boise, ID 83702-6754
Phone: (208) 706-9340
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (2)

  • 200 Montgomery Hwy Ste 125, Vestavia Hills, AL 35216-1840 — (205) 978-4352
  • 1665 Bonanza Dr, Park City, UT 84060-5127 — (435) 649-7640

Specialties & licences

Sports Medicine (Family Medicine) Physician (primary) Taxonomy 207QS0010X · Licence O-1471 (ID)

Record details

NPI number1417223892
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorNo
NPI enumeratedMarch 29, 2012
Last updated in NPPESSeptember 16, 2021
Certification dateSeptember 16, 2021
Mailing addressPo Box 27128, Salt Lake City, UT 84127-0128

Medicare enrollment

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

Medicare specialtySPORTS MEDICINE
Medical schoolAT STILL UN OF HLTH SCIENCES, COL OF OSTEO MED, MESA
Graduated 2012 (14 years in practice)
Group practice St Lukes Clinic-Treasure Valley Llc — 1150 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations3 on file with Medicare

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