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 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 |
|---|
| 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 | 102 |
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 |
|---|
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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