ELEANOR ROSE WILSON PA-C
NPI 1336871623
Physician Assistant in Boise, ID

Q: What is Eleanor Wilson's NPI number?

The NPI number for Eleanor Wilson is 1336871623. It was assigned to this individual provider in the NPPES registry on June 27, 2022.

Q: What is Eleanor Wilson'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 Eleanor Wilson was last updated on July 28, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 12 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 June 27, 2022PECOS EnrolledAccepts Medicare Assignment

100 E IDAHO ST STE 302, BOISE, ID 83712(208) 343-7501 Get Directions Write a Review

NPPES record last updated: July 28, 2025. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Mar 17, 2025, Dec 8, 2023 (2 updates tracked since 2023).

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About Eleanor Rose Wilson Pa-c NPPES

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

ELEANOR ROSE WILSON PA-C (NPI 1336871623) is an individual physician assistant in Boise, Idaho, licensed in Idaho (PA-2592) and active in the NPI registry since June 2022. She is enrolled in Medicare PECOS, is affiliated with St Luke's Regional Medical Center, and maintains a secondary practice location in Pocatello.

NPPES Registry Identity

NPI1336871623

Entity TypeIndividualFemale

Primary Taxonomy363A00000X

Provider Legal NameELEANOR ROSE WILSONCredential: PA-C

Location Address100 E IDAHO ST STE 302Boise, ID 83712-6269

Mailing Address190 E Bannock StBoise, ID 83712-6241

Phone(208) 343-7501

Sole ProprietorNo

Medical School CMSOtherGraduated 2023

Enumeration DateJune 27, 2022

Last NPPES UpdateJuly 28, 20252 updates tracked since enumeration

NPPES CertifiedJuly 28, 2025

✔ NPI 1336871623 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-2592

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.

100 E IDAHO ST STE 302, Boise, ID 83712

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Secondary Practice Location 1

Location 1921 S. 8th Ave, Stop 8253Pocatello, ID 83709 · Phone (208) 282-4726

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Moda Health Plan, Inc., 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

Eleanor Rose Wilson 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 ID1951751528

PECOS Enrollment IDI20231221003322

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.

Hospital Affiliations CMS Care Compare 2

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

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 83712 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 6

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

STACI JAE THOMAS WHNP-BC

Nurse Practitioner (Women's Health)