MRS. MARY WELBORN PA
NPI 1699457754
Physician Assistant in Boise, ID

Q: What is Mary Welborn's NPI number?

The NPI number for Mary Welborn is 1699457754. It was assigned to this individual provider in the NPPES registry on August 7, 2023. The provider is also known as Miss Mary Flowers.

Q: What is Mary Welborn'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 Mary Welborn was last updated on November 4, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 9 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 August 07, 2023PECOS EnrolledAccepts Medicare Assignment

190 E BANNOCK ST FL 10, BOISE, ID 83712(208) 381-5500(208) 381-2555 Get Directions Write a Review

NPPES record last updated: November 4, 2025. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Nov 4, 2025, Aug 7, 2023 (2 updates tracked since 2023).

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About Mrs. Mary Welborn Pa NPPES

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

MRS. MARY WELBORN PA (NPI 1699457754) is an individual physician assistant in Boise, Idaho and active in the NPI registry since August 2023. She is enrolled in Medicare PECOS, is affiliated with St Luke's Regional Medical Center, and maintains a secondary practice location in Boise.

NPPES Registry Identity

NPI1699457754

Entity TypeIndividualFemale

Primary Taxonomy363A00000X

Provider Legal NameMRS. MARY WELBORNCredential: PA

Location Address190 E BANNOCK ST FL 10Boise, ID 83712-6241

Mailing Address190 E Bannock StBoise, ID 83712-6241

Phone(208) 381-5500

Fax(208) 381-2555

Sole ProprietorNo

Medical School CMSOtherGraduated 2025

Enumeration DateAugust 7, 2023

Last NPPES UpdateNovember 4, 20252 updates tracked since enumeration

NPPES CertifiedNovember 4, 2025

✔ NPI 1699457754 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyPhysician AssistantPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363A00000X

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.

Also ListedStudent in an Organized Health Care Education/Training ProgramTaxonomy 390200000X

190 E BANNOCK ST FL 10, Boise, ID 83712

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Other Names 1

Former Name (1)Miss Mary Flowers

Secondary Practice Location 1

Location 111515 W Aldershot DrBoise, ID 83709-5559 · Phone (208) 881-1183

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. Mary Welborn 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 ID5395236384

PECOS Enrollment IDI20251118001861

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 10

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

DAVID E NIELSON PA-C

Physician Assistant