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KELLY BEACH PA
NPI 1649668765
Physician Assistant in Boise, ID

Active since December 23, 2014PECOS Enrolled
300 W MYRTLE ST, SUITE 100, BOISE, ID 83702(208) 472-9082(208) 472-9083 Get Directions Write a Review

NPPES record last updated: January 8, 2016. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Kelly Beach Pa NPPES

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

KELLY BEACH PA (NPI 1649668765) is an individual physician assistant in Boise, Idaho, licensed in Idaho (PA-1208) and active in the NPI registry since December 2014. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1649668765
Entity TypeIndividualFemale
Primary Taxonomy363A00000X
Provider Legal NameKELLY BEACHCredential: PA
Location Address300 W MYRTLE ST, SUITE 100Boise, ID 83702-7690
Mailing AddressPo Box 191050Boise, ID 83719-1050 · (208) 955-6522 · Fax (208) 955-6503
Phone(208) 472-9082
Fax(208) 472-9083
Sole ProprietorNo
Enumeration DateDecember 23, 2014
Last NPPES UpdateJanuary 8, 2016
✔ NPI 1649668765 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-1208
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.
300 W MYRTLE ST, Boise, ID 83702
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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Kelly Beach Pa is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

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.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 83702 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 3

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

DR. APRIL DILLION DO
Family Medicine
300 W MYRTLE ST, SUITE 100
BOISE, ID 83702
Ada County (208) 472-9082
RACHEL N. LEVITCH PHYSICIAN ASSISTANT
Physician Assistant (Medical)
300 W MYRTLE ST, SUITE 100
BOISE, ID 83702
Ada County (208) 472-9082
ALLIANCE MEDICAL GROUP, LLC
Family Medicine
300 W MYRTLE ST
BOISE, ID 83702
Ada County (208) 472-9082

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 Kelly Beach's NPI number?

The NPI number for Kelly Beach is 1649668765. It was assigned to this individual provider in the NPPES registry on December 23, 2014.

Where is Kelly Beach located?

Kelly Beach practices at 300 W Myrtle St Suite 100, Boise, ID 83702. The listed phone number is (208) 472-9082.

What is Kelly Beach's specialty?

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

Is Kelly Beach enrolled in Medicare?

Yes. Kelly Beach is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Kelly Beach was last updated on January 8, 2016. NPI Profile syncs with the weekly NPPES data releases published by CMS.