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PHILLIP IMPERIO
NPI 1790504959
Physician Assistant - Medical in Boise, ID

Active since October 05, 2024PECOS Enrolled

NPPES record last updated: May 13, 2025. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: May 13, 2025, Oct 5, 2024 (2 updates tracked since 2024).

About Phillip Imperio NPPES

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

PHILLIP IMPERIO (NPI 1790504959) is an individual medical provider in Boise, Idaho and active in the NPI registry since October 2024. He is enrolled in Medicare PECOS and is a graduate of Other (2024).

NPPES Registry Identity

NPI1790504959
Entity TypeIndividualMale
Primary Taxonomy363AM0700X
Provider Legal NamePHILLIP IMPERIO
Location Address633 N 4TH STBoise, ID 83702-4510
Mailing Address633 N 4th StBoise, ID 83702-4510
Phone(208) 342-9800
Sole ProprietorNo
Medical School CMSOtherGraduated 2024
Enumeration DateOctober 5, 2024
Last NPPES UpdateMay 13, 20252 updates tracked since enumeration
NPPES CertifiedMay 13, 2025
✔ NPI 1790504959 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPhysician Assistant · MedicalPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363AM0700X
633 N 4TH 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)

Phillip Imperio is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID4981102878
PECOS Enrollment IDI20250811000885
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.

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.

DANIEL G DEAN PA-C
Physician Assistant
633 N 4TH ST
BOISE, ID 83702
Ada County (208) 342-9800
MICHELLE KEEN PA-C
Physician Assistant
633 N 4TH ST
BOISE, ID 83702
Ada County (208) 342-9800
SANDRA A THOMPSON MD
Anesthesiology (Pain Medicine)
633 N 4TH ST
BOISE, ID 83702
Ada County (208) 342-9800
ALEXANDRA SEAMAN PA
Physician Assistant
633 N 4TH ST
BOISE, ID 83702
Ada County (208) 342-9800
PAIN CENTER INC
Clinic/Center (Pain)
633 N 4TH ST
BOISE, ID 83702
Ada County (208) 342-9800
ALLA OSIPCHUK APRN, ACNS-BC
Clinical Nurse Specialist (Adult Health)
633 N 4TH ST
BOISE, ID 83702
Ada County (208) 342-9800

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 Phillip Imperio's NPI number?

The NPI number for Phillip Imperio is 1790504959. It was assigned to this individual provider in the NPPES registry on October 5, 2024.

Where is Phillip Imperio located?

Phillip Imperio practices at 633 N 4th St, Boise, ID 83702. The listed phone number is (208) 342-9800.

What is Phillip Imperio's specialty?

The primary specialty registered for this NPI is Physician Assistant, specializing in Medical, with taxonomy code 363AM0700X.

Is Phillip Imperio enrolled in Medicare?

Yes. Phillip Imperio is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Phillip Imperio was last updated on May 13, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 14 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.