Idaho Surgical Assistants PLLC
NPI 1225389414ActiveOrganization· Physician Assistant· Boise, ID
Physician Assistant in Boise, Idaho, registered in NPPES in September 2012. The authorized official on file is Reanna Park, Billing Specialist.
Overview
| NPI | 1225389414 |
|---|---|
| Status | Active |
| Entity type | Organization |
| NPI issued | Sep 27, 2012 |
| Last updated in NPPES | Sep 27, 2012 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Physician Assistant Primary | 363A00000X | PA-325 | ID |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Oct 9, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 10, 2026 | No match | — |
| New York OMIG · Nov 10, 2026 | No match | — |
| Ohio Medicaid · Nov 10, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 10, 2026 | No match | — |
| Washington HCA · Nov 10, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Not in the public enrollment file of Oct 1, 2026 |
|---|
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