Individual provider Active NPI

Jaiden Randy Hiskey, PA-C

  • Physician Assistant
  • Idaho Falls, ID
National Provider Identifier
1083455042
Registry record updated Jan 29, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
8971575 Issued in ID
Practice address
2235 E 25TH St
Idaho Falls, ID 83404-7519
Phone
(208) 521-7593
NPI assigned
Jun 4, 2024
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 29, 2026

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 8971575 ID Primary

Addresses

Primary practice location

2235 E 25TH St
Idaho Falls, ID 83404-7519

Mailing address

2235 E 25TH St
Idaho Falls, ID 83404-7519
Phone (208) 521-7593

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
I20260114002976 ID Practitioner - Physician Assistant 0648756197 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2025
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mountain View Hospital LLCGroup PAC ID 4486562774, 272 clinicians

Practice addresses (Care Compare)

2325 Coronado St
Idaho Falls, ID 83404-7407
Phone (208) 557-2700

Hospital & facility affiliations

  • Mountain View Hospital Hospital, Idaho Falls, ID, CCN 130065
  • Eastern Idaho Regional Medical Center Hospital, Idaho Falls, ID, CCN 130018

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
8971575IDMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Mountain View Hospital LLC CurrentSince Nov 7, 2025 Accepting new patients
Mountain View Hospital Physician Organization Past Accepting new patients

Locations

2235 E 25th St
Idaho Falls, ID 83404
Phone (208) 521-7593

2325 Coronado St
Idaho Falls, ID 83404
Phone (208) 528-7686

2730 Channing Way
Idaho Falls, ID 83404
Phone (208) 542-7100

404 N 2nd E
Rexburg, ID 83440
Phone (208) 359-1770

380 Walker Dr
Rexburg, ID 83440
Phone (208) 356-9559

Organizations & group practices 2

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 2

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": "1717459200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1769644800000",
    "number": "1083455042",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2235 E 25TH ST",
            "city": "IDAHO FALLS",
            "state": "ID",
            "postal_code": "834047519",
            "telephone_number": "208-521-7593"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2235 E 25TH ST",
            "city": "IDAHO FALLS",
            "state": "ID",
            "postal_code": "834047519",
            "telephone_number": "208-521-7593"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HISKEY",
        "first_name": "JAIDEN",
        "middle_name": "RANDY",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-06-04",
        "last_updated": "2026-01-29",
        "certification_date": "2026-01-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "ID",
            "license": "8971575",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Idaho Falls, ID

Sources for this page

Verify at the official NPI Registry.