Individual provider Active NPI

Malinda Paige Westendorf

  • Physician Assistant
  • Mountain Home, ID
National Provider Identifier
1003546276
Registry record updated Oct 26, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA-2379 Issued in ID
Practice address
465 McKenna Dr
Mountain Home, ID 83647-2143
Phone
(208) 587-9703
NPI assigned
Jun 12, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 26, 2022

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X
Student in an Organized Health Care Education/Training Program 390200000X
Physician Assistant 363A00000X PA-2379 ID Primary

Addresses

Primary practice location

465 McKenna Dr
Mountain Home, ID 83647-2143

Mailing address

190 E Bannock St
Boise, ID 83712-6241
Phone (208) 381-8866

Other practice location 1

921 S 8th Ave Stop 8253
Pocatello, ID 83209-0002
Phone (208) 282-4726

Other practice location 2

2674 S Spring Bar Way
Meridian, ID 83642-4628
Phone (208) 559-6609

Other names 1

  • Lindy Westendorf Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ID
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20221110002619 ID Practitioner - Physician Assistant 8820465495 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
St Lukes Clinic-Treasure Valley LLC 1,155 clinicians

Practice addresses (Care Compare)

465 McKenna Dr
Mountain Home, ID 83647-2143
Phone (208) 587-9703

805 N 6TH
Mountain Home, ID 83647-2207
Phone (208) 587-2450

840 N 4TH
Mountain Home, ID 83647-2137
Phone (208) 322-1680

890 N 6TH
Mountain Home, ID 83647-2206
Phone (208) 587-8401

895 N 6TH
Mountain Home, ID 83647-2207
Phone (208) 587-8401

Hospital & facility affiliations

  • St Luke'S Elmore Medical Center Hospital, Mountain Home, ID, CCN 131311
  • St Luke'S Regional Medical Center Hospital, Boise, ID, CCN 130006

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
PA-2379IDMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
St Lukes Clinic-Treasure Valley LLC CurrentSince Oct 28, 2022 Accepting new patients
St Lukes Regional Medical Center Past Accepting new patients

Locations

190 E Bannock St
Boise, ID 83712
Phone (208) 381-2378

610 W Hays St
Boise, ID 83702
Phone (208) 345-3530

840 N 4th E
Mountain Home, ID 83647
Phone (208) 587-1850

465 McKenna Dr
Mtn Home, ID 83647
Phone (208) 587-9703

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 4

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1654992000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1666742400000",
    "number": "1003546276",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "190 E BANNOCK ST",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837126241",
            "telephone_number": "208-381-8866"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "465 MCKENNA DR",
            "city": "MOUNTAIN HOME",
            "state": "ID",
            "postal_code": "836472143",
            "telephone_number": "208-587-9703"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "921 S 8th Ave Stop 8253",
            "address_purpose": "LOCATION",
            "city": "Pocatello",
            "state": "ID",
            "postal_code": "832090002",
            "country_code": "US",
            "telephone_number": "208-282-4726",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2674 S Spring Bar Way",
            "address_purpose": "LOCATION",
            "city": "Meridian",
            "state": "ID",
            "postal_code": "836424628",
            "country_code": "US",
            "telephone_number": "208-559-6609",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WESTENDORF",
        "first_name": "MALINDA",
        "middle_name": "PAIGE",
        "name_prefix": "Ms.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-06-12",
        "last_updated": "2022-10-26",
        "certification_date": "2022-10-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "ID",
            "license": "PA-2379",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LINDY",
            "last_name": "WESTENDORF",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Mountain Home, ID

Sources for this page

Verify at the official NPI Registry.