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ADA WEST DERMATOLOGY, PC
NPI 1518973338
Dermatology in Meridian, ID

Active since August 01, 2006CLIA Certified · 6 labs
1618 S MILLENIUM WAY STE 100, MERIDIAN, ID 83642(208) 884-3376(208) 884-0858 Get Directions Write a Review

NPPES record last updated: May 18, 2026. Verified against the NPPES registry weekly; last sync: October 25, 2026.

Record update history: May 18, 2026, Jun 4, 2025, Nov 11, 2022 and 1 more (4 updates tracked since 2018).

About Ada West Dermatology, Pc NPPES

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

ADA WEST DERMATOLOGY, PC (NPI 1518973338) is a healthcare organization registered as a dermatology in Meridian, Idaho and active in the NPI registry since August 2006. The organization holds 6 active CLIA laboratory certificates and lists Colleen Jones, Cfo, as its authorized official.

NPPES Registry Identity

NPI1518973338
Entity TypeOrganization
Primary Taxonomy207N00000X
Legal Business NameADA WEST DERMATOLOGY, PC
Location Address1618 S MILLENIUM WAY STE 100Meridian, ID 83642-6457
Mailing Address1618 S. Millennium Way, Suite 100Meridian, ID 83642-6457 · (208) 884-3376 · Fax (208) 884-0858
Phone(208) 884-3376
Fax(208) 884-0858
Organization SubpartNo
Authorized OfficialColleen JonesCfo · (208) 884-3376
Enumeration DateAugust 1, 2006
Last NPPES UpdateMay 18, 20264 updates tracked since enumeration
NPPES CertifiedMay 18, 2026
✔ NPI 1518973338 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDermatologyAllopathic & Osteopathic Physicians
Taxonomy Code207N00000X
License✔ Licensed in ID · M5986
Definition
A dermatologist is trained to diagnose and treat pediatric and adult patients with benign and malignant disorders of the skin, mouth, external genitalia, hair and nails, as well as a number of sexually transmitted diseases. The dermatologist has had additional training and experience in the diagnosis and treatment of skin cancers, melanomas, moles and other tumors of the skin, the management of contact dermatitis and other allergic and nonallergic skin disorders, and in the recognition of the skin manifestations of systemic (including internal malignancy) and infectious diseases. Dermatologists have special training in dermatopathology and in the surgical techniques used in dermatology. They also have expertise in the management of cosmetic disorders of the skin such as hair loss and scars and the skin changes associated with aging.
1618 S MILLENIUM WAY STE 100, Meridian, ID 83642
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Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Accepted Insurance

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

Medicare Participation & PECOS CMS

Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Ada West Dermatology, Pc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

18

Medicare enrollment records show 18 clinicians reassign Medicare billing to Ada West Dermatology, PC, which bills Medicare for the services they deliver. Of these, 15 practice at this address. They are listed nearest first.

Clinicians by Medicare Specialty 4

Dermatology15
Internal Medicine1
Nurse Practitioner1
Pathology1

Clinicians, nearest first (18)

Peter Boothman, M.D.
Dermatology
NPI 1588018170
1618 S MILLENIUM WAY STE 100
Meridian, ID 83642
(208) 884-3376
✔ PECOS✔ Accepts MedicareSame address
Emily Boozalis, MD
Dermatology
NPI 1760927990
1618 S MILLENIUM WAY STE 100
Meridian, ID 83642
(208) 884-3376
✔ PECOS✔ Accepts MedicareSame address
Elizabeth Keiser, MD, MPH
Pathology
NPI 1942696711
1618 S MILLENIUM WAY
Meridian, ID 83642
(208) 884-3376
✔ PECOSSame address
Christine Measham, M.D.
Dermatology
NPI 1558321323
1618 S MILLENIUM WAY
Meridian, ID 83642
(208) 377-1969
✔ PECOSSame address
Mark Schwendiman, D.O.
Dermatology
NPI 1417184409
1618 S MILLENIUM WAY STE 100
Meridian, ID 83642
(208) 884-3376
✔ PECOS✔ Accepts MedicareSame address
Jennifer Scott, MD, PHD
Dermatology
NPI 1528590056
1618 S MILLENIUM WAY STE 100
Meridian, ID 83642
(208) 884-3376
✔ PECOS✔ Accepts MedicareSame address
Elizabeth Swanson, M.D.
Dermatology
NPI 1174596951
1618 S MILLENIUM WAY STE 100
Meridian, ID 83642
(208) 884-3376
✔ PECOS✔ Accepts MedicareSame address
Ryan Thorpe
Dermatology
NPI 1568880995
1618 S MILLENIUM WAY STE 100
Meridian, ID 83642
(208) 884-3376
✔ PECOS✔ Accepts MedicareSame address
Whitney Vinson, MD
Dermatology
NPI 1447781539
1618 S MILLENIUM WAY STE 100
Meridian, ID 83642
(208) 884-3376
✔ PECOS✔ Accepts MedicareSame address
Gregory Wells, M.D.
Dermatology
NPI 1871609370
1618 MILLENIUM WAY SUITE 100
Meridian, ID 83642
(208) 884-3376
✔ PECOS✔ Accepts MedicareSame address
Ryan Wells, PHARM.D., M.D.
Internal Medicine
NPI 1710997200
1618 S MILLENIUM WAY STE 100
Meridian, ID 83642
(208) 884-3376
✔ PECOS✔ Accepts MedicareSame address
Daniel Winchester, MD
Dermatology
NPI 1740628023
1618 S MILLENIUM WAY STE 100
Meridian, ID 83642
(208) 884-3376
✔ PECOS✔ Accepts MedicareSame address
Randall Burr, M.D.
Dermatology
NPI 1740217603
1618 S. MILLENNIUM WAY SUITE 100
Meridian, ID 83642
(208) 884-3376
✔ PECOSSame address
Jennifer Cook, APRN
Nurse Practitioner
NPI 1073858049
1618 S MILLENIUM WAY
Meridian, ID 83642
(208) 884-3376
✔ PECOS✔ Accepts MedicareSame address
Alan Pitt, MD
Dermatology
NPI 1659301950
1618 S. MILLENNIUM WAY SUITE 100
Meridian, ID 83642
(208) 884-3376
✔ PECOSSame address
Vijay Balakrishnan, MD
Dermatology
NPI 1104311596
655 EUCLID AVE STE 304
National City, CA 91950
(619) 267-8303
✔ PECOS✔ Accepts Medicare753 mi
Maura Holcomb, M.D.
Dermatology
NPI 1013276237
7616 BRANFORD PL STE 240
Sugar Land, TX 77479
(281) 240-4313
✔ PECOS✔ Accepts Medicare1,496 mi
Sara Colby, MD
Dermatology
NPI 1821178716
3200 3RD ST S STE 200
Jacksonville Beach, FL 32250
(813) 321-1786
✔ PECOS✔ Accepts Medicare2,123 mi

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

CLIA Laboratory Certificates CMS CLIA 6

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Compliance 13D0895833

Ada West Dermatology · Meridian, ID
Active · expires Jan 3, 2028
CLIA Number13D0895833
Laboratory TypePhysician Office
Certificate Effective DateJanuary 4, 2026
Certificate Expiration DateJanuary 3, 2028
Laboratory DirectorDaniel Winchester
Laboratory Phone(208) 884-3376
Laboratory LocationAda West Dermatology1618 S Millennium Way Ste #200, Meridian, ID 83642
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory after an inspection that finds the laboratory to be in compliance with all applicable CLIA requirements.

Certificate for Provider-Performed Microscopy Procedures (PPMP) 13D2178556

Ada West Dermatology · Meridian, ID
Active · expires Jan 8, 2027
CLIA Number13D2178556
Laboratory TypePhysician Office
Certificate Effective DateJanuary 9, 2025
Certificate Expiration DateJanuary 8, 2027
Laboratory DirectorGregory L. Wells
Laboratory Phone(208) 955-0804
Laboratory LocationAda West Dermatology1618 S Millennium Way Ste 100, Meridian, ID 83642
CLIA data matches this NPI record on: Address Name
This certificate is issued to a laboratory in which a physician, midlevel practitioner or dentist performs no tests other than the microscopy procedures. This certificate permits the laboratory to also perform waived tests.

Certificate of Accreditation 13D2047540

Ada West Dermatopathology Lab · Meridian, ID
Active · expires Jan 19, 2028
CLIA Number13D2047540
Laboratory TypeHistology Lab
Certificate Effective DateJanuary 20, 2026
Certificate Expiration DateJanuary 19, 2028
Laboratory DirectorDr. Gregory Wells
Laboratory Phone(208) 991-5665
Laboratory LocationAda West Dermatopathology Lab1618 S Millennium Way #220, Meridian, ID 83642
CLIA data matches this NPI record on: Address
This is a certificate that is issued to a laboratory on the basis of the laboratory's accreditation by an accreditation organization approved by CMS.

Certificate of Waiver 13D2332626

Ada West Dermatology Dba Ada West Research LLC · Meridian, ID
Active · expires Oct 21, 2027
CLIA Number13D2332626
Laboratory TypePhysician Office
Certificate Effective DateOctober 22, 2025
Certificate Expiration DateOctober 21, 2027
Laboratory DirectorMark Schwendiman
Laboratory Phone(208) 884-3376
Laboratory LocationAda West Dermatology Dba Ada West Research LLC4574 N Ten Mile Rd Ste 120, Meridian, ID 83646
CLIA data matches this NPI record on: Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Certificate of Compliance 13D2171439

Ada West Dermatology · Meridian, ID
Active · expires Mar 3, 2027
CLIA Number13D2171439
Laboratory TypePhysician Office
Certificate Effective DateMarch 4, 2025
Certificate Expiration DateMarch 3, 2027
Laboratory DirectorRyan B. Thorpe
Laboratory Phone(208) 884-3376
Laboratory LocationAda West Dermatology4574 N Ten Mile Rd Ste 110, Meridian, ID 83646
CLIA data matches this NPI record on: Name Phone
This certificate is issued to a laboratory after an inspection that finds the laboratory to be in compliance with all applicable CLIA requirements.

Certificate of Compliance 13D2267834

Ada West Dermatology-Barber Station · Boise, ID
Active · expires Nov 17, 2026
CLIA Number13D2267834
Laboratory TypePhysician Office
Certificate Effective DateNovember 18, 2024
Certificate Expiration DateNovember 17, 2026
Laboratory DirectorPeter K. Boothman
Laboratory Phone(208) 884-3376
Laboratory LocationAda West Dermatology-Barber Station3100 E Barber Valley Dr, Boise, ID 83716
CLIA data matches this NPI record on: Name Phone
This certificate is issued to a laboratory after an inspection that finds the laboratory to be in compliance with all applicable CLIA requirements.

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 Ada West Dermatology, PC's NPI number?

The NPI number for Ada West Dermatology, PC is 1518973338. It was assigned to this organization in the NPPES registry on August 1, 2006.

Where is Ada West Dermatology, PC located?

Ada West Dermatology, PC is located at 1618 S Millenium Way Ste 100, Meridian, ID 83642. The listed phone number is (208) 884-3376.

What is Ada West Dermatology, PC's specialty?

The primary specialty registered for this NPI is Dermatology with taxonomy code 207N00000X.

Is Ada West Dermatology, PC enrolled in Medicare?

Yes. Ada West Dermatology, PC is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Ada West Dermatology, PC?

According to the CMS Revalidation Reassignment List (October 2026 release), 18 clinicians in 4 Medicare specialties reassign their Medicare billing to Ada West Dermatology, PC. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. The largest specialties are Dermatology (15), Internal Medicine (1) and Nurse Practitioner (1). Of these, 15 practice at this address. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Does Ada West Dermatology, PC hold CLIA laboratory certificates?

Yes. 6 active CLIA laboratory certificates are associated with this NPI under the federal Clinical Laboratory Improvement Amendments program. The certificates are listed in the CLIA Laboratory Certificates section above.

What insurance does Ada West Dermatology, PC accept?

Health plans from Moda Health Plan, Inc. and Molina Healthcare list Ada West Dermatology, PC 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 Ada West Dermatology, PC was last updated on May 18, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 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.