KELLY ANDERSON
NPI 1295465284
Physician Assistant in Boise, ID

Q: What is Kelly Anderson's NPI number?

The NPI number for Kelly Anderson is 1295465284. It was assigned to this individual provider in the NPPES registry on June 13, 2022.

Q: What is Kelly Anderson's specialty?

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

Q: When was this NPI record last updated?

The NPPES record for Kelly Anderson was last updated on October 28, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 years 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.

Active since June 13, 2022PECOS EnrolledAccepts Medicare Assignment

6051 W EMERALD ST, BOISE, ID 83704(208) 302-5150(208) 302-5155 Get Directions Write a Review

NPPES record last updated: October 28, 2022. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Oct 28, 2022, Sep 1, 2022 (2 updates tracked since 2022).

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About Kelly Anderson NPPES

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

KELLY ANDERSON (NPI 1295465284) is an individual physician assistant in Boise, Idaho, licensed in Idaho (PA-2336) and active in the NPI registry since June 2022. She is enrolled in Medicare PECOS, is affiliated with St Lukes Magic Valley Medical Center, and maintains a secondary practice location in Boise.

NPPES Registry Identity

NPI1295465284

Entity TypeIndividualFemale

Primary Taxonomy363A00000X

Provider Legal NameKELLY ANDERSON

Location Address6051 W EMERALD STBoise, ID 83704-8969

Mailing Address3340 E Goldstone DrMeridian, ID 83642-1026 · (208) 367-5170 · Fax (208) 367-5180

Phone(208) 302-5150

Fax(208) 302-5155

Sole ProprietorNo

Medical School CMSOtherGraduated 2022

Enumeration DateJune 13, 2022

Last NPPES UpdateOctober 28, 20222 updates tracked since enumeration

NPPES CertifiedOctober 28, 2022

✔ NPI 1295465284 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 · PA-2336

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.

6051 W EMERALD ST, Boise, ID 83704

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Secondary Practice Location 1

Location 12506 1/2 N Heights DrBoise, ID 83702-2836 · Phone (813) 415-9645

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Providence Health Plan, Select Health.Insurance ›

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

Kelly Anderson 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 ID5294102851

PECOS Enrollment IDI20221110002094

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.

Areas of Expertise CMS Part B claims 3

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more 99213

This is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.

57 services56 patients

Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more 99214

This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.

45 services44 patients

New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more 99203

This service involves an initial office or outpatient visit for a new patient. The healthcare professional will spend 30-44 minutes understanding your health history, current issues, and discussing possible treatment plans. It's a comprehensive evaluation to start your healthcare journey.

15 services15 patients

Hospital Affiliations CMS Care Compare 2

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

St Lukes Magic Valley Medical Center

Acute Care Hospitals · Twin Falls, ID

5/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number130002

Location801 Pole Line Road WestTwin Falls, ID 83301 · Twin Falls County

Emergency services Birthing friendly

Saint Alphonsus Regional Medical Center

Acute Care Hospitals · Boise, ID

4/5 CMS rating

OwnershipVoluntary non-profit - Church

CMS Certification Number130007

Location1055 North Curtis RoadBoise, ID 83706 · Ada County

Emergency services Birthing friendly

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 20

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

BETHANY KENDALL MAZE FNP

Nurse Practitioner (Family)