Gordon Bradley Greaves, PA is a medicare enrolled "Physician Assistant" in Wilder, Idaho. He graduated from nursing school in 2002 and has 23 years of diverse experience with area of expertise as Physician Assistant. His current practice location is
15821 Allendale Rd, Wilder, Idaho. You can reach out to his office (for appointments etc.) via phone at
(208) 278-2863.
Gordon Bradley Greaves is licensed to practice in Idaho (license number PA615) and he also participates in the medicare program. He
accepts medicare assignments (which means he accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance) and his NPI Number is 1699708131.
Provider's Profile
| Full Name | Gordon Bradley Greaves |
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| Gender | Male |
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| Speciality | Physician Assistant |
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| Experience | 23 Years |
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| Location | 15821 Allendale Rd, Wilder, Idaho |
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| Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
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Medical Education and Training:
- Gordon Bradley Greaves graduated from nursing school in 2002
NPI Data:
- NPI Number: 1699708131
- Provider Enumeration Date: 07/08/2006
- Last Update Date: 04/14/2025
Medicare PECOS Information:
- PECOS PAC ID: 6204739113
- Enrollment ID: I20061101000271
Medical Identifiers
Medical identifiers for Gordon Bradley Greaves such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1699708131 | NPI | - | NPPES |
| 807537400 | Medicaid | ID | |
| 16369 | Other | CA | PA LICENSE |
| PA615 | Other | ID | IDAHO BOARD OF MEDICINE |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 363A00000X | Physician Assistant | 16369 (California) | Secondary |
| 363LP0808X | Nurse Practitioner - Psychiatric/mental Health | PA615 (Idaho) | Secondary |
| 363A00000X | Physician Assistant | PA615 (Idaho) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Gordon Bradley Greaves is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
|---|
Gordon Bradley Greaves, PA
15821 Allendale Rd,
Wilder, ID 83676-5864
Ph: (208) 278-2863 | Gordon Bradley Greaves, PA
15821 Allendale Rd,
Wilder, ID 83676-5864
Ph: (208) 278-2863 |
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