Individual provider Active NPI

Kira Beth Sandon, PA-C

  • Physician Assistant
  • Coeur D Alene, ID
National Provider Identifier
1104100676
Registry record updated Jun 17, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA-1444 Issued in ID
Practice address
1233 N Northwood Center CT Ste 101
Coeur D Alene, ID 83814-6190
Phone
(208) 457-4211
Fax
(208) 773-1473
NPI assigned
Oct 3, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 17, 2026

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 PA-1444 ID Primary
Medical Physician Assistant 363AM0700X PA-1444 ID
Surgical Physician Assistant 363AS0400X PA-1444 ID

Addresses

Primary practice location

1233 N Northwood Center CT Ste 101
Coeur D Alene, ID 83814-6190

Mailing address

1233 N Northwood Center CT Ste 101
Coeur D Alene, ID 83814-6190
Phone (208) 457-4211

Other practice location 1

1296 E Polston Ave Ste C
Post Falls, ID 83854-5217
Phone (208) 625-6700

Other practice location 2

8552 N Government Way
Hayden, ID 83835-9280
Phone (208) 457-4211

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
I20161208002427 ID Practitioner - Physician Assistant 6002196003 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Adam J Olscamp MD PCGroup PAC ID 4284947334, 11 clinicians

Practice addresses (Care Compare)

1233 N Northwood Ctr CT
Suite 101
Coeur D Alene, ID 83814-6190
Phone (208) 457-4211

8552 N Government Way
Hayden, ID 83835-9280
Phone (208) 457-4211

Hospital & facility affiliations

  • Northwest Specialty Hospital Hospital, Post Falls, ID, CCN 130066
  • Kootenai Health Hospital, Coeur D'Alene, ID, CCN 130049

Merit-based Incentive Payment System (MIPS)

Final score
87.76 of 100Reported as group
Quality
87.24
Promoting interoperability
100
Improvement activities
40
Cost
71.97

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Adam J Olscamp MD PC Physician Assistant CurrentSince Aug 1, 2019 Accepting new patients
Kootenai Health, Inc. Past Accepting new patients

Locations

1233 N Northwood Center Ct
Ste 101
Coeur D Alene, ID 83814
Phone (208) 215-2450

1233 N Northwood Center Ct
Coeur D Alene, ID 83814
Phone (208) 457-4211

8552 N Government Way
Hayden, ID 83835
Phone (208) 457-4211

Interoperability endpoints

  • Direct secure messaging: kira.sandon.1@28236.direct.athenahealth.com
  • Direct secure messaging: kira.sandon.2@2944.direct.athenahealth.com

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 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": "1317600000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1781654400000",
    "number": "1104100676",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1233 N NORTHWOOD CENTER CT STE 101",
            "city": "COEUR D ALENE",
            "state": "ID",
            "postal_code": "838146190",
            "telephone_number": "208-457-4211",
            "fax_number": "208-773-1473"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1233 N NORTHWOOD CENTER CT STE 101",
            "city": "COEUR D ALENE",
            "state": "ID",
            "postal_code": "838146190",
            "telephone_number": "208-457-4211",
            "fax_number": "208-773-1473"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1296 E Polston Ave Ste C",
            "address_purpose": "LOCATION",
            "city": "Post Falls",
            "state": "ID",
            "postal_code": "838545217",
            "country_code": "US",
            "telephone_number": "208-625-6700",
            "fax_number": "208-625-6701",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "8552 N Government Way",
            "address_purpose": "LOCATION",
            "city": "Hayden",
            "state": "ID",
            "postal_code": "838359280",
            "country_code": "US",
            "telephone_number": "208-457-4211",
            "fax_number": "208-773-1473",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SANDON",
        "first_name": "KIRA",
        "middle_name": "BETH",
        "name_prefix": "Ms.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-10-03",
        "last_updated": "2026-06-17",
        "certification_date": "2026-06-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "ID",
            "license": "PA-1444",
            "primary": true
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "ID",
            "license": "PA-1444",
            "primary": false
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "ID",
            "license": "PA-1444",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Coeur D Alene, ID

Sources for this page

Verify at the official NPI Registry.