MRS. KATIE DIANA WAITES PA-C
NPI 1306964994
Physician Assistant in Boise, ID

Q: What is Katie Waites's NPI number?

The NPI number for Katie Waites is 1306964994. It was assigned to this individual provider in the NPPES registry on March 26, 2007. The provider is also known as Miss Katie Diana Mallaburn Emt-P, PA.

Q: What is Katie Waites'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 Katie Waites was last updated on April 4, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 16 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.

Active since March 26, 2007PECOS EnrolledAccepts Medicare Assignment

701 E PARKCENTER BLVD, BOISE, ID 83706(208) 381-4210(208) 381-2045 Get Directions Write a Review

NPPES record last updated: April 4, 2025. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Apr 4, 2025, Nov 1, 2023, Feb 25, 2023 and 1 more (4 updates tracked since 2021).

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About Mrs. Katie Diana Waites Pa-c NPPES

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

MRS. KATIE DIANA WAITES PA-C (NPI 1306964994) is an individual physician assistant in Boise, Idaho, licensed in Idaho (PA-1501) and active in the NPI registry since March 2007. She is enrolled in Medicare PECOS, is affiliated with St Luke's Regional Medical Center, and maintains a secondary practice location in Aurora.

NPPES Registry Identity

NPI1306964994

Entity TypeIndividualFemale

Primary Taxonomy363A00000X

Provider Legal NameMRS. KATIE DIANA WAITESCredential: PA-C

Location Address701 E PARKCENTER BLVDBoise, ID 83706-6528

Mailing Address190 E Bannock StBoise, ID 83712-6241

Phone(208) 381-4210

Fax(208) 381-2045

Sole ProprietorNo

Medical School CMSOtherGraduated 2016

Enumeration DateMarch 26, 2007

Last NPPES UpdateApril 4, 20254 updates tracked since enumeration

NPPES CertifiedApril 4, 2025

✔ NPI 1306964994 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-1501

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.

701 E PARKCENTER BLVD, Boise, ID 83706

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Other Names 1

Former Name (1)Miss Katie Diana Mallaburn Emt-p, Pa

Secondary Practice Location 1

Location 1275 S Aspen St Stop 89Aurora, CO 80011-9562 · Phone (720) 277-9493

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include 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 and accepts Medicare assignment

Mrs. Katie Diana Waites Pa-c 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 ID7719266675

PECOS Enrollment IDI20170810002312

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

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.

18 services17 patients

Hospital Affiliations CMS Care Compare 3

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

St Luke's Regional Medical Center

Acute Care Hospitals · Boise, ID

5/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number130006

Location190 East Bannock StreetBoise, ID 83712 · Ada County

Emergency services Birthing friendly

St Luke's Nampa Medical Center

Acute Care Hospitals · Nampa, ID

5/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number130071

Location9850 West St Lukes DriveNampa, ID 83687 · Canyon County

Emergency services Birthing friendly

St Luke's Wood River Medical Center

Critical Access Hospitals · Ketchum, ID

OwnershipVoluntary non-profit - Private

CMS Certification Number131323

Location100 Hospital DriveKetchum, ID 83340 · Blaine County

Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 83706 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.

DR. THORNTON E BRYAN III MD

Family Medicine