Michaela Shields, PSYD

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

9871472 Issued in ID

Practice address

600 N Robbins Rd Ste 100
Boise, ID 83702-4539

Phone

(208) 381-9037

Fax

(208) 385-3616

NPI assigned

Sep 14, 2022

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in UT, NC, ID3 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 3

Specialty

Clinical Psychologist

Education

Other, 2022

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

St Lukes Clinic-Treasure Valley LLCGroup PAC ID 4981878402, 1,155 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• St Lukes Clinic-Treasure Valley LLC

  • Family Medicine Physician
  • Boise, ID
  • NPI 1326336058
  Medicare reassignment Care Compare group NPD
• Lecci Psychological Services, PLLC

  • Psychologist
  • Wilmington, NC
  • NPI 1811976426
  Medicare reassignment NPD
• State of Utah

  • Psychiatric Hospital
  • Provo, UT
  • NPI 1811978620
  Medicare reassignment NPD
• St Lukes Clinic-Treasure Valley LLC

  • Family Medicine Physician
  • Mountain Home, ID
  • NPI 1417297821
  NPD

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

{
    "created_epoch": "1663113600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1761868800000",
    "number": "1053033282",
    "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"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "600 N ROBBINS RD STE 100",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837024539",
            "telephone_number": "208-381-9037",
            "fax_number": "208-385-3616"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1300 E Center St",
            "address_purpose": "LOCATION",
            "city": "Provo",
            "state": "UT",
            "postal_code": "846063554",
            "country_code": "US",
            "telephone_number": "801-344-4215",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SHIELDS",
        "first_name": "MICHAELA",
        "credential": "PSYD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-09-14",
        "last_updated": "2025-10-31",
        "certification_date": "2025-10-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "ID",
            "license": "9871472",
            "primary": true
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "UT",
            "license": "12966160-2504",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• SHH Medical Group Idaho, LLC
• Xiaoming Shi, MD
• Katrina Shibambo
• Joshua Shieh
• Ali Shields, LCSW
• Jeffrey S Shilt, MD
• Keita Shimada, MK, LAT, ATC
• Diana San Juan Shimko, CRNA
• Jane M Shimon, ED.D., A.T.C.
• Daniel Shin, DO

• Clinical Psychologist in Boise, ID
• Providers in Boise, ID by specialty
• Clinical Psychologist in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 31, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.