Individual provider Active NPI

Wesley J Rowlette, PA-C

  • Physician Assistant
  • Meridian, ID
National Provider Identifier
1023624129
Registry record updated Oct 1, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA-2613 Issued in ID
Practice address
1209 N Summerbrook Ave Ste 100
Meridian, ID 83642-8750
Phone
(208) 938-5823
Fax
(208) 938-5306
NPI assigned
Sep 23, 2020
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 1, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA-2613 ID Primary

Addresses

Primary practice location

1209 N Summerbrook Ave Ste 100
Meridian, ID 83642-8750

Mailing address

1209 N Summerbrook Ave Ste 100
Meridian, ID 83642-8750
Phone (208) 938-5823

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
I20240105002172 ID Practitioner - Physician Assistant 5496175937 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Idaho Ear Clinic PLLCGroup PAC ID 2668703687, 6 clinicians

Practice addresses (Care Compare)

1209 N Summerbrook Ave
Suite 100
Meridian, ID 83642-8750
Phone (208) 938-5823

Hospital & facility affiliations

  • St Luke'S Regional Medical Center Hospital, Boise, ID, CCN 130006
  • St Luke'S Nampa Medical Center Hospital, Nampa, ID, CCN 130071

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PA-2613IDMDPhysician Assistant

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/CBDHBD/Endpoint/CBDHBD

Organizations & group practices 1

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 3

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": "1600819200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1759276800000",
    "number": "1023624129",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1209 N SUMMERBROOK AVE STE 100",
            "city": "MERIDIAN",
            "state": "ID",
            "postal_code": "836428750",
            "telephone_number": "208-938-5823",
            "fax_number": "208-938-5306"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1209 N SUMMERBROOK AVE STE 100",
            "city": "MERIDIAN",
            "state": "ID",
            "postal_code": "836428750",
            "telephone_number": "208-938-5823",
            "fax_number": "208-938-5306"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROWLETTE",
        "first_name": "WESLEY",
        "middle_name": "J",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-09-23",
        "last_updated": "2025-10-01",
        "certification_date": "2025-10-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "ID",
            "license": "PA-2613",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Meridian, ID

Sources for this page

Verify at the official NPI Registry.