| Kelly Anderson, | |
|
6051 W Emerald St, Boise, ID 83704-8969 | |
| (208) 302-5150 | |
| (208) 302-5155 |
| Full Name | Kelly Anderson |
|---|---|
| Gender | Female |
| Speciality | Physician Assistant |
| Experience | 4 Years |
| Location | 6051 W Emerald St, Boise, Idaho |
| Accepts Medicare Assignments | Yes. She accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1295465284 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 363A00000X | Physician Assistant | (* (Not Available)) | Secondary |
| 363A00000X | Physician Assistant | PA-2336 (Idaho) | Primary |
| Facility Name | Location | Facility Type |
|---|---|---|
| Saint Alphonsus Regional Medical Center | Boise, ID | Hospital |
| St Luke's Magic Valley Rmc | Twin falls, ID | Hospital |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Saint Alphonsus Regional Medical Center Inc | 3476462359 | 672 |
| Entity Name | Saint Alphonsus Regional Medical Center Inc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1649357716 PECOS PAC ID: 3476462359 Enrollment ID: O20040204001036 |
| Entity Name | Saint Alphonsus Medical Center- Ontario Inc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1093034159 PECOS PAC ID: 1456488899 Enrollment ID: O20120229000024 |
| Mailing Address | Practice Location Address |
|---|---|
| Kelly Anderson, 3340 E Goldstone Dr, Meridian, ID 83642-1026 Ph: (208) 367-5170 | Kelly Anderson, 6051 W Emerald St, Boise, ID 83704-8969 Ph: (208) 302-5150 |
Brittany Guthrie, PA-C Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 1072 N Liberty Street, Ste 303, Boise, ID 83704 Phone: 208-302-4400 Fax: 208-302-4255 |
Jessica Jerdin, PA-C Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 6165 W Emerald St, Boise, ID 83704 Phone: 208-302-3900 Fax: 208-302-3955 |
Kaydon J Lloyd, PA-C Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 999 N Curtis Rd Ste 415, Boise, ID 83706 Phone: 208-302-2600 Fax: 208-302-2625 |
Polina Kokoulina, PA-C Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 900 N Liberty St, Ste 101, Boise, ID 83704 Phone: 208-367-5050 Fax: 208-367-5151 |
Natalie Marie Hague, PA Physician Assistant Medicare: Medicare Enrolled Practice Location: 100 E Warm Springs Ave Ste B, Boise, ID 83712 Phone: 208-381-6930 Fax: 208-381-6931 |
Micah Ray Tobin, PA Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 10583 W Lake Hazel Rd, Boise, ID 83709 Phone: 208-302-5950 Fax: 208-302-5955 |
Jason H. Mcbride, PA-C Physician Assistant Medicare: Medicare Enrolled Practice Location: 1055 N Curtis Rd, Boise, ID 83706 Phone: 208-367-3131 |