Individual provider Active NPI

Audrey J Schaefer, PA-C

  • Physician Assistant
  • Idaho Falls, ID
National Provider Identifier
1073847133
Registry record updated Nov 20, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA810 Issued in ID
Practice address
3100 Channing Way
Idaho Falls, ID 83404-7533
Phone
(208) 227-2008
NPI assigned
Sep 22, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 20, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA810 ID Primary
Surgical Physician Assistant 363AS0400X PA810 ID

Addresses

Primary practice location

3100 Channing Way
Idaho Falls, ID 83404-7533

Mailing address

3100 Channing Way
Idaho Falls, ID 83404-7533
Phone (208) 535-4103

Other practice location 1

2860 Channing Way
#117
Idaho Falls, ID 83404-7531
Phone (208) 535-4470

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address aschaefer@sjmc.cernerdirect.com Direct Teton County Hospital District

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ID, WY2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20100202000734 ID Practitioner - Physician Assistant 0648313478 Reassigns benefits to 2 organizations
I20240618003454 WY Practitioner - Physician Assistant 0648313478 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Teton County Hospital DistrictGroup PAC ID 4880582295, 107 clinicians

Practice addresses (Care Compare)

555 E Broadway Ave
Jackson, WY 83001-8640

625 E Broadway Ave
Jackson, WY 83001-8642
Phone (307) 733-3636

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
81.82 of 100Reported as group
Quality
67.1
Promoting interoperability
98
Improvement activities
40
Cost
73.98

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
51225CAMDPhysical Therapy Assistant
PA810IDMDSurgical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Teton County Hospital District CurrentSince Jun 4, 2024 Accepting new patients
Pathology Associates of Idaho Falls P a PastSince Jun 1, 2022 Accepting new patients

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 1

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": "1253577600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1732060800000",
    "number": "1073847133",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3100 CHANNING WAY",
            "city": "IDAHO FALLS",
            "state": "ID",
            "postal_code": "834047533",
            "telephone_number": "208-535-4103"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3100 CHANNING WAY",
            "city": "IDAHO FALLS",
            "state": "ID",
            "postal_code": "834047533",
            "telephone_number": "208-227-2008"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2860 Channing Way",
            "address_2": "#117",
            "address_purpose": "LOCATION",
            "city": "Idaho Falls",
            "state": "ID",
            "postal_code": "834047531",
            "country_code": "US",
            "telephone_number": "208-535-4470",
            "fax_number": "208-535-4476",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SCHAEFER",
        "first_name": "AUDREY",
        "middle_name": "J",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-09-22",
        "last_updated": "2024-11-20",
        "certification_date": "2024-11-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "ID",
            "license": "PA810",
            "primary": true
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "ID",
            "license": "PA810",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "aschaefer@sjmc.cernerdirect.com",
            "affiliation": "Y",
            "endpointDescription": "direct messaging",
            "affiliationName": "Teton County Hospital District",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "625 E Broadway Ave",
            "city": "Jackson",
            "state": "WY",
            "country_code": "US",
            "postal_code": "830018642",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Idaho Falls, ID

Sources for this page

Verify at the official NPI Registry.