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HAILEY LIZABETH COLLETTE MS
NPI 1003761636
Dietitian, Registered - Nutrition, Pediatric in Boise, ID

Active since February 27, 2026
305 E JEFFERSON ST, BOISE, ID 83712(208) 381-7081(208) 381-6009 Get Directions Write a Review

NPPES record last updated: March 30, 2026. Verified against the NPPES registry weekly; last sync: October 25, 2026.

About Hailey Lizabeth Collette Ms NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

HAILEY LIZABETH COLLETTE MS (NPI 1003761636) is an individual nutrition, pediatric provider in Boise, Idaho and active in the NPI registry since February 2026. She maintains a secondary practice location in Boise and is a graduate of Other (2025).

NPPES Registry Identity

NPI1003761636
Entity TypeIndividualFemale
Primary Taxonomy133VN1004X
Provider Legal NameHAILEY LIZABETH COLLETTECredential: MS
Location Address305 E JEFFERSON STBoise, ID 83712-6231
Mailing Address190 E Bannock StBoise, ID 83712-6241
Phone(208) 381-7081
Fax(208) 381-6009
Sole ProprietorNo
Medical School CMSOtherGraduated 2025
Enumeration DateFebruary 27, 2026
Last NPPES UpdateMarch 30, 2026
NPPES CertifiedMarch 30, 2026
✔ NPI 1003761636 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDietitian, Registered · Nutrition, PediatricDietary & Nutritional Service Providers
Taxonomy Code133VN1004X
Definition
An individual who is a Board Certified Specialist in Pediatric Nutrition and applies evidence-based nutrition knowledge in providing medical nutrition therapy for pediatric patients. Specialists work directly with healthy and/or ill children (newborn up to 21 years of age) as well as children with special health care needs in a variety of settings (hospitals, community-based and/or family-centered programs, education programs, home, etc.), OR indirectly through management, care coordination, education, quality improvement, or research practice linked specifically to pediatric nutrition.
305 E JEFFERSON ST, Boise, ID 83712
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Secondary Practice Location 1

Location 1190 E Bannock StBoise, ID 83712-6241 · Phone (208) 706-5437

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Moda Health Plan, Inc., PacificSource Health Plans, Providence Health Plan and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Hailey Lizabeth Collette Ms is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID4183196918
PECOS Enrollment IDI20260612001682

Medicare Billing Reassignment

Medicare enrollment records show Hailey Collette reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

St Lukes Clinic-Treasure Valley LLC
Same address
Family Medicine
190 E BANNOCK ST
Boise, ID 83712
  • Reassigned Medicare billing, Idaho enrollment
  • 1,312 clinicians in this Medicare group
NPI 1326336058 (208) 381-2222

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

ARIANA LAWRENCE MS, RD, LD
Dietitian, Registered
305 E JEFFERSON ST
BOISE, ID 83712
Ada County (208) 381-7081
NATALIE PARRISH LCSW
Social Worker (Clinical)
305 E JEFFERSON ST
BOISE, ID 83712
Ada County (208) 381-7340
DR. PAUL CHRISTIAN NEVILLE O.D.
Optometrist
305 E JEFFERSON ST
BOISE, ID 83712
Ada County (208) 381-6910
LINDSEY RAE WENDEL CPNP-PC
Nurse Practitioner (Pediatrics)
305 E JEFFERSON ST
BOISE, ID 83712
Ada County (208) 381-7011
JASON JOHN OVEROCKER PA-C
Physician Assistant (Surgical)
305 E JEFFERSON ST
BOISE, ID 83712
Ada County (208) 381-7370
KODY MICHAEL DUCLOS RD, LD
Dietitian, Registered (Nutrition, Pediatric)
305 E JEFFERSON ST
BOISE, ID 83712
Ada County (208) 381-7081
KELSEY EILEEN MOE PCP-NP
Nurse Practitioner (Pediatrics)
305 E JEFFERSON ST
BOISE, ID 83712
Ada County (208) 706-5437
ELIZABETH ASHLEY BLACK MD
Pediatrics (Pediatric Nephrology)
305 E JEFFERSON ST
BOISE, ID 83712
Ada County (208) 381-7336

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Hailey Collette's NPI number?

The NPI number for Hailey Collette is 1003761636. It was assigned to this individual provider in the NPPES registry on February 27, 2026.

Where is Hailey Collette located?

Hailey Collette practices at 305 E Jefferson St, Boise, ID 83712. The listed phone number is (208) 381-7081.

What is Hailey Collette's specialty?

The primary specialty registered for this NPI is Dietitian, Registered, specializing in Nutrition, Pediatric, with taxonomy code 133VN1004X.

Is Hailey Collette enrolled in Medicare?

Yes. Hailey Collette is registered in the Medicare PECOS enrollment system.

Which organization bills Medicare for Hailey Collette's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Hailey Collette reassigns Medicare benefits to St Lukes Clinic-Treasure Valley LLC (Boise, ID). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Hailey Collette's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Hailey Collette accept?

Health plans from Moda Health Plan, Inc., PacificSource Health Plans, Providence Health Plan and Select Health list Hailey Collette as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Hailey Collette was last updated on March 30, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 7 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.