KELLEY WOLFF PA
NPI 1609963081
Physician Assistant in Boise, ID

Q: What is Kelley Wolff's NPI number?

The NPI number for Kelley Wolff is 1609963081. It was assigned to this individual provider in the NPPES registry on October 6, 2006.

Q: What is Kelley Wolff'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 Kelley Wolff was last updated on February 4, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 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 October 06, 2006PECOS EnrolledAccepts Medicare Assignment

1000 E PARK BLVD STE 120, BOISE, ID 83712(208) 381-4100(208) 381-4101 Get Directions Write a Review

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

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About Kelley Wolff Pa NPPES

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

KELLEY WOLFF PA (NPI 1609963081) is an individual physician assistant in Boise, Idaho, licensed in Idaho (PA-639) and active in the NPI registry since October 2006. She is enrolled in Medicare PECOS, is affiliated with St Luke's Regional Medical Center, and is a graduate of Other (2006).

NPPES Registry Identity

NPI1609963081

Entity TypeIndividualFemale

Primary Taxonomy363A00000X

Provider Legal NameKELLEY WOLFFCredential: PA

Location Address1000 E PARK BLVD STE 120Boise, ID 83712-7793

Mailing Address190 E Bannock StBoise, ID 83712-6241 · (208) 381-2222

Phone(208) 381-4100

Fax(208) 381-4101

Sole ProprietorNo

Medical School CMSOtherGraduated 2006

Enumeration DateOctober 6, 2006

Last NPPES UpdateFebruary 4, 2026

NPPES CertifiedFebruary 4, 2026

✔ NPI 1609963081 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-639

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.

1000 E PARK BLVD STE 120, Boise, ID 83712

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Accepted Insurance

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

Kelley Wolff Pa 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 ID4183625536

PECOS Enrollment IDI20070126000571

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 2

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 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.

85 services71 patients

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.

68 services62 patients

Hospital Affiliations CMS Care Compare

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

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.

Referred Medical Equipment & Supplies CMS DME claims 3

Durable medical equipment, devices and supplies this provider ordered from DME suppliers for patients, from Medicare fee-for-service claims.

Oxygen concentrator, single delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate E1390

DME-Oxygen and Supplies · category DC002N

1 supplier12 claims12 services$67.60 avg. paid by Medicare

Portable oxygen concentrator, rental E1392

DME-Oxygen and Supplies · category DC002N

1 supplier12 claims12 services$36.62 avg. paid by Medicare

Supply allowance for therapeutic continuous glucose monitor (cgm), includes all supplies and accessories, 1 month supply = 1 unit of service K0553

DME-Other DME · category DE017N

1 supplier17 claims17 services$184.70 avg. paid by Medicare

Dollar amounts are the average Medicare paid the supplier per service. They are not the cost to the patient.

Other Providers at the Same Location NPPES 5

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

PHYLLIS D TEZENO-BURRIS NP

Nurse Practitioner (Family)