NPIMap

Individual provider Active NPI

Alec Meyerhoeffer

  • Physician Assistant
  • Boise, ID
National Provider Identifier
1184322513
Registry record updated Oct 2, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA-2445 Issued in ID
Practice address
222 N 2ND St Ste 215
Boise, ID 83702-6130
Phone
(208) 381-5500
Fax
(208) 381-2555
NPI assigned
Feb 15, 2023
Last updated
Oct 2, 2024By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 2, 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 PA-2445 ID Primary

Addresses

Primary practice location

222 N 2ND St Ste 215
Boise, ID 83702-6130

Mailing address

190 E Bannock St
Boise, ID 83712-6241

Other practice location 1

13500 Pleasant Vly Rd
Kuna, ID 83634-2709
Phone (208) 336-0740

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
I20241011001554 ID Practitioner - Physician Assistant 5193257426 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
St Lukes Clinic-Treasure Valley LLCGroup PAC ID 4981878402, 1,155 clinicians

Practice addresses (Care Compare)

222 N 2ND St
Boise, ID 83702-6130

520 S Eagle Rd
Meridian, ID 83642-6355

608 W Hays St
Boise, ID 83702-5511
Phone (208) 381-5970

610 W Hays St
Boise, ID 83702-5511
Phone (208) 381-5970

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
St Lukes Clinic-Treasure Valley LLC CurrentSince Oct 2, 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

190 E Bannock St
#10
Boise, ID 83712

222 N 2nd St
Ste 215
Boise, ID 83702
Phone (208) 342-2706

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

520 S Eagle Rd
Ste 1201
Meridian, ID 83642
Phone (208) 706-5988

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

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": "1676419200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1727827200000",
    "number": "1184322513",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "190 E BANNOCK ST",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837126241"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "222 N 2ND ST STE 215",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837026130",
            "telephone_number": "208-381-5500",
            "fax_number": "208-381-2555"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "13500 Pleasant Vly Rd",
            "address_purpose": "LOCATION",
            "city": "Kuna",
            "state": "ID",
            "postal_code": "836342709",
            "country_code": "US",
            "telephone_number": "208-336-0740",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MEYERHOEFFER",
        "first_name": "ALEC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2023-02-15",
        "last_updated": "2024-10-02",
        "certification_date": "2024-10-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "ID",
            "license": "PA-2445",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boise, ID

Sources for this page

Verify at the official NPI Registry.