Individual provider Active NPI

Ryan Casey

  • Physician Assistant
  • Meridian, ID
National Provider Identifier
1144908252
Registry record updated Apr 24, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
1648 NW 1St St
Meridian, ID 83642-2212
Phone
(208) 888-9393
Fax
(208) 888-9525
NPI assigned
Jul 10, 2023
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 24, 2024

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 Primary

Addresses

Primary practice location

1648 NW 1St St
Meridian, ID 83642-2212

Mailing address

PO Box 191050
Boise, ID 83719-1050
Phone (208) 985-1423

Other practice location 1

21262 Beach Blvd Apt 201
Huntington Beach, CA 92648-5712
Phone (714) 749-0771

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
I20240425002658 ID Practitioner - Physician Assistant 8820445166 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Alliance Medical Group LLCGroup PAC ID 3971544685, 132 clinicians

Practice addresses (Care Compare)

10482 W Carlton Bay Dr
Garden City, ID 83714-5143
Phone (208) 955-6500

11197 W Fairview Ave
Boise, ID 83713-7935
Phone (208) 378-8011

1375 N Happy Valley Rd
Nampa, ID 83687-5280
Phone (208) 809-2869

1900 W Chinden Blvd
Meridian, ID 83646-6690
Phone (208) 809-2860

260 S Ten Mile Rd
Meridian, ID 83642-6100
Phone (208) 809-2872

512 N 21St Ave
Caldwell, ID 83605-4368
Phone (208) 809-2875

6052 W State St
Boise, ID 83703-2739
Phone (208) 947-1947

8971 W Overland Rd
Boise, ID 83709-1651
Phone (208) 378-4288

Merit-based Incentive Payment System (MIPS)

Final score
84.87 of 100Reported as group
Quality
77.29
Promoting interoperability
97
Improvement activities
40
Cost
74.78

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Alliance Medical Group, LLC CurrentSince Apr 29, 2024 Accepting new patients
Pioneer Sports & Pain Center LLC CurrentSince Jan 1, 2026 Accepting new patients
Alliance Medical Group, LLC CurrentSince Apr 29, 2024 Accepting new patients
Alliance Medical Group, LLC Past Accepting new patients

Locations

10482 W Carlton Bay Dr
Garden City, ID 83714
Phone (208) 454-9690

757 E Wythe Creek Ct
#102
Kuna, ID 83634
Phone (208) 922-4908

1648 NW 1st St
Meridian, ID 83642
Phone (208) 888-9393

1900 W Chinden Blvd
Meridian, ID 83646
Phone (208) 809-2860

Interoperability endpoints

  • Direct secure messaging: ryan.casey@phmg.eclinicaldirectplus.com

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.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1688947200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1713916800000",
    "number": "1144908252",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 191050",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837191050",
            "telephone_number": "208-985-1423",
            "fax_number": "208-955-6501"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1648 NW 1ST ST",
            "city": "MERIDIAN",
            "state": "ID",
            "postal_code": "836422212",
            "telephone_number": "208-888-9393",
            "fax_number": "208-888-9525"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "21262 Beach Blvd Apt 201",
            "address_purpose": "LOCATION",
            "city": "Huntington Beach",
            "state": "CA",
            "postal_code": "926485712",
            "country_code": "US",
            "telephone_number": "714-749-0771",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CASEY",
        "first_name": "RYAN",
        "name_prefix": "Mr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-07-10",
        "last_updated": "2024-04-24",
        "certification_date": "2024-04-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Meridian, ID

Sources for this page

Verify at the official NPI Registry.