OrganizationActive
Idaho Physical Medicine & Rehabilitation
NPI 1497969604 · Physician Assistant · Boise, ID
Provider details
- NPI number
- 1497969604
- Entity type
- Organization
- Primary specialty
- Physician AssistantPhysician Assistants & Advanced Practice Nursing Providers
- Parent organization
- Idaho Physical Medicine & Rehabilitation
- Organization subpart
- Yes
- Authorized official
- Sharon Lee, Administrator(208) 489-5160
Specialties & taxonomies
Physician Assistants & Advanced Practice Nursing Providers
Profile Score
Detailed profile(89/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
19 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
600 Robbins Rd
Boise, ID 83702-4539
Phone: (208) 489-4016
Fax: (208) 489-4015
Street-level locationGet directions
Mailing address
600 N. Robbins Rd
Boise, ID 83702
Other names (DBA / former)
- Other name
- PA Grp
Registry dates
- Enumerated
- 2007-05-09
- Last updated
- 2010-03-16
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.