Individual provider Active NPI

Thomas Ryan Giles, PA-C

  • Physician Assistant
  • Boise, ID
National Provider Identifier
1114436672
Registry record updated Sep 13, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA-2317 Issued in ID
Practice address
190 E Bannock St
Boise, ID 83712-6241
Phone
(208) 381-2094
NPI assigned
Sep 27, 2017
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 13, 2022

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 PA184708 OR
Physician Assistant 363A00000X PA-2317 ID Primary

Addresses

Primary practice location

190 E Bannock St
Boise, ID 83712-6241

Mailing address

PO Box 3300
La Pine, OR 97739-3300

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
I20221012000231 ID Practitioner - Physician Assistant 9638435936 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Boise Radiology Group PLLCGroup PAC ID 9638153257, 64 clinicians

Practice addresses (Care Compare)

1210 NW 16TH St
Fruitland, ID 83619-2202
Phone (208) 381-2094

190 E Bannock St
Boise, ID 83712-6241
Phone (208) 381-2094

600 N Robbins Rd
Boise, ID 83702-4565
Phone (208) 489-4940

895 N 6TH St E
Mountain Home, ID 83647-2207
Phone (208) 381-2094

9850 St Lukes Dr
Nampa, ID 83687-7912
Phone (208) 505-2017

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
93.94 of 100Reported as group
Quality
92.87
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PA184708ORMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
St Lukes Clinic-Treasure Valley LLC CurrentSince Dec 12, 2024 Accepting new patients
St Lukes Regional Medical Center Past Accepting new patients

Locations

190 E Bannock St
Boise, ID 83712
Phone (208) 381-2378

610 W Hays St
Boise, ID 83702
Phone (208) 345-3530

100 E Idaho St
Boise, ID 83712
Phone (208) 343-3223

701 E Parkcenter Blvd
Boise, ID 83706
Phone (208) 381-6400

600 N Robbins Rd
Boise, ID 83702
Phone (208) 489-4444

3101 E State St
Eagle, ID 83616
Phone (208) 473-3100

1210 NW 16th St
Fruitland, ID 83619
Phone (208) 452-8600

3277 E Louise Dr
Ste 100
Meridian, ID 83642
Phone (208) 706-5217

3140 W Milano Dr
Ste 150
Meridian, ID 83646
Phone (208) 887-4775

520 S Eagle Rd
Meridian, ID 83642
Phone (208) 706-5000

895 N 6th E
Mtn Home, ID 83647
Phone (208) 580-2661

9850 W St Lukes Dr
Nampa, ID 83687
Phone (208) 205-7282

Interoperability endpoints

  • Direct secure messaging: tgiles276958@ahs.direct-ci.com

Organizations & group practices 3

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": "1506470400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1663027200000",
    "number": "1114436672",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3300",
            "city": "LA PINE",
            "state": "OR",
            "postal_code": "977393300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "190 E BANNOCK ST",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837126241",
            "telephone_number": "208-381-2094"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GILES",
        "first_name": "THOMAS",
        "middle_name": "RYAN",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-09-27",
        "last_updated": "2022-09-13",
        "certification_date": "2022-09-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "OR",
            "license": "PA184708",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "ID",
            "license": "PA-2317",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boise, ID

Sources for this page

Verify at the official NPI Registry.