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CASANDRA ODOMS
NPI 1205516697
Physician Assistant in Boise, ID

Active since July 20, 2023PECOS EnrolledAccepts Medicare Assignment
222 N 2ND ST STE 204, BOISE, ID 83702(208) 429-9100 Get Directions Write a Review

NPPES record last updated: January 5, 2026. Verified against the NPPES registry weekly; last sync: August 16, 2026.

Record update history: Jan 5, 2026, Jul 20, 2023 (2 updates tracked since 2023).

About Casandra Odoms NPPES

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

CASANDRA ODOMS (NPI 1205516697) is an individual physician assistant in Boise, Idaho, licensed in Idaho (5271988) and active in the NPI registry since July 2023. She is enrolled in Medicare PECOS and is a graduate of Other (2025).

NPPES Registry Identity

NPI1205516697
Entity TypeIndividualFemale
Primary Taxonomy363A00000X
Provider Legal NameCASANDRA ODOMS
Location Address222 N 2ND ST STE 204Boise, ID 83702-6130
Mailing Address222 N 2nd St Ste 204Boise, ID 83702-6130 · (208) 429-9100
Phone(208) 429-9100
Sole ProprietorNo
Medical School CMSOtherGraduated 2025
Enumeration DateJuly 20, 2023
Last NPPES UpdateJanuary 5, 20262 updates tracked since enumeration
NPPES CertifiedJanuary 5, 2026
✔ NPI 1205516697 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPhysician AssistantPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363A00000X
License✔ Licensed in ID · 5271988
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.
222 N 2ND ST STE 204, Boise, ID 83702
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Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Casandra Odoms is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID6002391356
PECOS Enrollment IDI20260403001362
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 83702 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 3

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

MELISA RANDALL PA
Physician Assistant
222 N 2ND ST STE 204
BOISE, ID 83702
Ada County (208) 429-9100
ASHLEY A DAVIS MD
Family Medicine
222 N 2ND ST STE 204
BOISE, ID 83702
Ada County (208) 429-9100
ALMA MARIE OSBORN N.P.
Registered Nurse (General Practice)
222 N 2ND ST STE 204
BOISE, ID 83702
Ada County (208) 429-9100

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 Casandra Odoms's NPI number?

The NPI number for Casandra Odoms is 1205516697. It was assigned to this individual provider in the NPPES registry on July 20, 2023.

Where is Casandra Odoms located?

Casandra Odoms practices at 222 N 2nd St Ste 204, Boise, ID 83702. The listed phone number is (208) 429-9100.

What is Casandra Odoms's specialty?

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

Is Casandra Odoms enrolled in Medicare?

Yes. Casandra Odoms is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

When was this NPI record last updated?

The NPPES record for Casandra Odoms was last updated on January 5, 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.