Ryan Burke, PA
Individual provider Active NPI Physician Assistant · Boise, ID
NPI 1194132860 · NPPES record last updated Feb 17, 2017
Key facts
- NPI
- 1194132860
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physician Assistant 363A00000X
- License
- PA-1179 (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
Organizations & group practices 19
Hospital & facility affiliations 7
Medicare Care Compare profile
- Specialty
- Physician Assistant
- Education
- Other, 2014
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Alliance Medical Group LLC
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
1474 N Meridian Rd
Kuna, ID 83634-2041
Phone (208) 809-2885
1475 N Cole Rd
Boise, ID 83704-8537
Phone (208) 809-2880
1895 McGrath Rd
Eagle, ID 83616-6243
Phone (208) 939-8200
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
4971 W Overland Rd
Boise, ID 83705-2822
Phone (208) 472-5050
6052 W State St
Boise, ID 83703-2739
Phone (208) 947-1947
8971 W Overland Rd
Boise, ID 83709-1651
Phone (208) 378-4288
Hospital & facility affiliations
- St Luke'S Regional Medical Center
- Saint Alphonsus Regional Medical Center
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in ID
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20140820000603 | ID | Practitioner - Physician Assistant | 4880812601 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Physician Assistant
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Alliance Medical Group, LLC | Family Medicine | Current | Accepting new patients |
| Alliance Medical Group, LLC | Family Medicine | Current |
Accepting new patients |
| Alliance Medical Group, LLC | Family Medicine | Past | Accepting new patients |
Locations
4971 W Overland Rd
Boise, ID 83705
Phone (208) 472-5050
8971 W Overland Rd
Boise, ID 83709
Phone (208) 378-4288
11197 W Fairview Ave
Boise, ID 83713
Phone (208) 378-8011
10482 W Carlton Bay Dr
Garden City, ID 83714
Phone (208) 454-9690
1900 W Chinden Blvd
Meridian, ID 83646
Phone (208) 809-2860
Interoperability endpoints
- ryan.burke@phmg.eclinicaldirectplus.com
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | PA-1179 | ID | Yes |
Addresses
Primary practice location
8971 W Overland Rd
Boise, ID 83709-1651
Mailing address
PO Box 191050
Boise, ID 83719-1050
Phone (208) 955-6522
Other providers in Boise, ID
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 17, 2017. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.