NPIMap

Individual provider Active NPI

Avery Magdalena Schick

  • Physician Assistant
  • Nampa, ID
National Provider Identifier
1114648615
Registry record updated Nov 29, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA-2357 Issued in ID
Practice address
1510 12TH Ave Rd Ste 200
Nampa, ID 83686-6008
Phone
(208) 302-6800
Fax
(208) 302-6855
NPI assigned
Sep 5, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 29, 2022

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 PA-2357 ID Primary

Addresses

Primary practice location

1510 12TH Ave Rd Ste 200
Nampa, ID 83686-6008

Mailing address

3340 E Goldstone Dr
Meridian, ID 83642-1026
Phone (208) 302-5170

Other names 1

  • Avery Magdalena White Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ID
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230710002687 ID Practitioner - Physician Assistant 6901265842 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Saint Alphonsus Regional Medical Center IncGroup PAC ID 3476462359, 672 clinicians

Practice addresses (Care Compare)

1510 12TH Ave Rd
Suite 200
Nampa, ID 83686-6008
Phone (208) 302-6899

1512 12TH Ave Rd
Suite 100
Nampa, ID 83686-6008
Phone (208) 467-1171

3025 W Cherry LN
Meridian, ID 83642-8531

Hospital & facility affiliations

  • Enhabit Home Health & Hospice Home health agency, Boise, ID, CCN 137006
  • Saint Alphonsus Regional Medical Center Hospital, Boise, ID, CCN 130007
  • Saint Alphonsus Medical Center - Nampa Hospital, Nampa, ID, CCN 130013
  • St Luke'S Regional Medical Center Hospital, Boise, ID, CCN 130006
  • St Luke'S Nampa Medical Center Hospital, Nampa, ID, CCN 130071

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Saint Alphonsus Regional Medical Center Inc CurrentSince Sep 1, 2022 Accepting new patients
Saint Alphonsus Regional Medical Center Inc CurrentSince Sep 1, 2022 Accepting new patients

Locations

3025 W Cherry Ln
Meridian, ID 83642
Phone (208) 302-6400

3025 W Cherry Ln
Ste B
Meridian, ID 83642
Phone (208) 302-6400

3340 E Goldstone Dr
Meridian, ID 83642
Phone (208) 302-9342

1510 12th Ave Rd
Ste 200
Nampa, ID 83686
Phone (208) 302-0600

Interoperability endpoints

  • Direct secure messaging: aschick2525351@direct.trinity-health.org

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 10

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": "1662336000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1669680000000",
    "number": "1114648615",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3340 E GOLDSTONE DR",
            "city": "MERIDIAN",
            "state": "ID",
            "postal_code": "836421026",
            "telephone_number": "208-302-5170",
            "fax_number": "208-302-5180"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1510 12TH AVE RD STE 200",
            "city": "NAMPA",
            "state": "ID",
            "postal_code": "836866008",
            "telephone_number": "208-302-6800",
            "fax_number": "208-302-6855"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCHICK",
        "first_name": "AVERY",
        "middle_name": "MAGDALENA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-09-05",
        "last_updated": "2022-11-29",
        "certification_date": "2022-11-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "ID",
            "license": "PA-2357",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "AVERY",
            "last_name": "WHITE",
            "middle_name": "MAGDALENA",
            "credential": "PA-C",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Nampa, ID

Sources for this page

Verify at the official NPI Registry.