Ms Krysta Nicole Carlson, PA-C is a medicare enrolled "Physician Assistant" in Homedale, Idaho. She graduated from nursing school in 2014 and has 12 years of diverse experience with area of expertise as Physician Assistant. She is a member of the group practice Clinicas Del Camino Real Inc, Community Health Clinics Inc, Community Health Clinics Inc and her current practice location is
108 E Idaho Ave, Homedale, Idaho. You can reach out to her office (for appointments etc.) via phone at
(208) 337-3189.
Ms Krysta Nicole Carlson is licensed to practice in Idaho (license number 5081403) and she also participates in the medicare program. She
accepts medicare assignments (which means she accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance) and her NPI Number is 1740698356.
Provider's Profile
| Full Name | Ms Krysta Nicole Carlson |
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| Gender | Female |
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| Speciality | Physician Assistant |
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| Experience | 12 Years |
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| Location | 108 E Idaho Ave, Homedale, Idaho |
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| Accepts Medicare Assignments | Yes. She 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:
- Ms Krysta Nicole Carlson graduated from nursing school in 2014
NPI Data:
- NPI Number: 1740698356
- Provider Enumeration Date: 07/27/2014
- Last Update Date: 06/05/2026
Medicare PECOS Information:
- PECOS PAC ID: 0244592657
- Enrollment ID: I20180323001118
Medical Identifiers
Medical identifiers for Ms Krysta Nicole Carlson such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1740698356 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 363A00000X | Physician Assistant | PA51782 (California) | Secondary |
| 363A00000X | Physician Assistant | 5081403 (Idaho) | Primary |
Medical Facilities Affiliation
Group Practice Association
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|
| Clinicas Del Camino Real Inc | 3173434396 | 99 |
| Community Health Clinics Inc | 4082527353 | 75 |
| Community Health Clinics Inc | 4082527353 | 75 |
Medicare Reassignments
Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Ms Krysta Nicole Carlson allows following entities to bill medicare on her behalf.
| Entity Name | Clinicas Del Camino Real Inc |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1679631907
PECOS PAC ID: 3173434396
Enrollment ID: O20040205001238 |
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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. Ms Krysta Nicole Carlson 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 |
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Ms Krysta Nicole Carlson, PA-C
Po Box 9,
Nampa, ID 83653-0009
Ph: (208) 467-4431 | Ms Krysta Nicole Carlson, PA-C
108 E Idaho Ave,
Homedale, ID 83628-5003
Ph: (208) 337-3189 |
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