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DEREK SCOTT AHLSTROM PA
NPI 1174096606
Physician Assistant in Boise, ID

Active since January 08, 2019PECOS Enrolled
7941 W RIFLEMAN ST, BOISE, ID 83704(208) 895-7950 Get Directions Write a Review

NPPES record last updated: March 28, 2024. Verified against the NPPES registry weekly; last sync: July 26, 2026.

Record update history: Mar 6, 2023, Aug 11, 2020, Jan 8, 2019 (3 updates tracked since 2019).

About Derek Scott Ahlstrom Pa NPPES

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

DEREK SCOTT AHLSTROM PA (NPI 1174096606) is an individual physician assistant in Boise, Idaho, licensed in Idaho (PA-1715) and active in the NPI registry since January 2019. He is enrolled in Medicare PECOS and maintains 8 additional practice locations.

NPPES Registry Identity

NPI1174096606
Entity TypeIndividualMale
Primary Taxonomy363A00000X
Provider Legal NameDEREK SCOTT AHLSTROMCredential: PA
Location Address7941 W RIFLEMAN STBoise, ID 83704-9001
Mailing Address1650 S Topaz WayMeridian, ID 83642-4474 · (208) 605-7070
Phone(208) 895-7950
Sole ProprietorNo
Enumeration DateJanuary 8, 2019
Last NPPES UpdateMarch 28, 20243 updates tracked since enumeration
NPPES CertifiedMarch 28, 2024
✔ NPI 1174096606 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPhysician AssistantPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363A00000X
Licenses✔ Licensed in ID · PA-1715✔ Licensed in WA · PA61522965
Definition
A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician.
7941 W RIFLEMAN ST, Boise, ID 83704
Open in Google Maps ↗

Secondary Practice Locations 8

Location 16600 W Emerald StBoise, ID 83704-8738 · Phone (208) 609-9020
Location 22335 E State AveMeridian, ID 83642-8808 · Phone (208) 672-1801
Location 39292 W Barnes DrBoise, ID 83709-1554 · Phone (208) 795-3515
Location 47416 212th St SWEdmonds, WA 98026-7602 · Phone (425) 245-5800
Location 5924 S Pines Rd Ste 101Spokane Valley, WA 99206-5423 · Phone (509) 299-8160
Location 62111 N Northgate Way Ste 101Seattle, WA 98133-9018 · Phone (206) 309-3740
Location 72111 N Northgate Way Ste 100Seattle, WA 98133-9018 · Phone (425) 502-9945
Location 8847 Parkcentre Way Ste 7Nampa, ID 83651-1794 · Phone (208) 229-6050

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.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Derek Scott Ahlstrom Pa is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 83704 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$81.13 typical visit price
range $52.44 – $160.17
Typical copayment $20.28 (range $13.11 – $40.04)
Most-billed visit code 99203
Established Patient
$65.77 typical visit price
range $16.68 – $130.93
Typical copayment $16.44 (range $4.17 – $32.73)
Most-billed visit code 99213
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 11

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

ASHWOOD RECOVERY LLC
Clinic/Center (Mental Health (Including Community Mental Health Center))
7941 W RIFLEMAN ST
BOISE, ID 83704
Ada County (208) 895-7950
JENNIFER ALEJANDRA RADILLA QUIJAS LMSW
Social Worker (Clinical)
7941 W RIFLEMAN ST
BOISE, ID 83704
Ada County (208) 895-7950
GAYLEE LYNN HOFF LCSW
Social Worker (Clinical)
7941 W RIFLEMAN ST
BOISE, ID 83704
Ada County (208) 855-7950
ROBERT JAMES DUNFEE CADC 11922
Counselor (Addiction (Substance Use Disorder))
7941 W RIFLEMAN ST
BOISE, ID 83704
Ada County (208) 810-2706
ERIKA L SCARBERRY
Counselor (Addiction (Substance Use Disorder))
7941 W RIFLEMAN ST
BOISE, ID 83704
Ada County (208) 895-7950
MR. THOMAS J CHILDERS-SCOTT LMSW
Social Worker (Clinical)
7941 W RIFLEMAN ST
BOISE, ID 83704
Ada County (208) 895-7950
ASHWOOD RECOVERY LLC
Clinic/Center (Rehabilitation, Substance Use Disorder)
7941 W RIFLEMAN ST
BOISE, ID 83704
Ada County (208) 895-7950
EMILY J RUSSELL-SMITH LMSW
Social Worker
7941 W RIFLEMAN ST
BOISE, ID 83704
Ada County (208) 895-7950

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 Derek Ahlstrom's NPI number?

The NPI number for Derek Ahlstrom is 1174096606. It was assigned to this individual provider in the NPPES registry on January 8, 2019.

Where is Derek Ahlstrom located?

Derek Ahlstrom practices at 7941 W Rifleman St, Boise, ID 83704. The listed phone number is (208) 895-7950.

What is Derek Ahlstrom's specialty?

The primary specialty registered for this NPI is Physician Assistant with taxonomy code 363A00000X.

Is Derek Ahlstrom enrolled in Medicare?

Yes. Derek Ahlstrom is registered in the Medicare PECOS enrollment system.

What insurance does Derek Ahlstrom accept?

Health plans from Moda Health Plan, Inc., PacificSource Health Plans and Providence Health Plan list Derek Ahlstrom 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 Derek Ahlstrom was last updated on March 28, 2024. NPI Profile syncs with the weekly NPPES data releases published by CMS.