Shane McIntyre, PA

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

TLP-034 Issued in ID

Practice address

8971 W Overland Rd
Boise, ID 83709-1651

Phone

(208) 378-4288

Fax

(208) 378-4297

NPI assigned

Jul 15, 2014

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

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

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: shane.mcintyre@phmg.eclinicaldirectplus.com
• Direct secure messaging: smcintyre1563790@direct.trinity-health.org

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.

• Cep America, LLC

  dba Vituity

  • Emergency Medicine Physician
  • Boise, ID
  • NPI 1811357023
  Medicare reassignment
• Cep America, LLC

  dba Vituity

  • Emergency Medicine Physician
  • Nampa, ID
  • NPI 1982064192
  NPD
• Cep America LLC

  • Emergency Medicine Physician
  • Fort Lauderdale, FL
  • NPI 1700747946
  NPD

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

{
    "created_epoch": "1405382400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1405382400000",
    "number": "1184031866",
    "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": "208-955-6522",
            "fax_number": "208-955-6503"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8971 W OVERLAND RD",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837091651",
            "telephone_number": "208-378-4288",
            "fax_number": "208-378-4297"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCINTYRE",
        "first_name": "SHANE",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-07-15",
        "last_updated": "2014-07-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "ID",
            "license": "TLP-034",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kennedy Anne McGurkin
• Jeanette McIlhenny, LMSW
• Mariah Jo McIntier
• Katherine McIntosh
• Michelle Anne McIntosh, PHARMD
• Pennie Jeanine McKay, M.A., L.C.P.C., L.M.
• Dana Marie McKee, APRN
• Jake McKee
• Jason Storm McKee, DPT, PT
• Kyan McKeever, RN

• Physician Assistant in Boise, ID
• Providers in Boise, ID by specialty
• Physician Assistant in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 15, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.