Nicolas J. Allen, PA-C
Individual provider Active NPI Physician Assistant · Boise, ID
NPI 1205910551 · NPPES record last updated Nov 10, 2012
Key facts
- NPI
- 1205910551
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physician Assistant 363A00000X
- License
- PA644 (ID)
- Practice address
- 703 S Americana Blvd
Ste 120
Boise, ID 83702-5099 - Phone
- (208) 323-2600
- NPI assigned
- Oct 24, 2006
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 2
Hospital & facility affiliations 9
Medicare Care Compare profile
- Specialty
- Physician Assistant
- Education
- Other, 2006
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Idaho Urologic Institute PA
Practice addresses (Care Compare)
222 N 2ND St
Suite 115
Boise, ID 83702-6129
Phone (208) 639-4900
2855 E Magic View Dr
Meridian, ID 83642-6245
Phone (208) 639-4900
6195 E Hunt Ave
Nampa, ID 83687-8317
Phone (208) 639-4900
Hospital & facility affiliations
- Saint Alphonsus Medical Center - Nampa
- Saint Alphonsus Regional Medical Center
- St Luke'S Regional Medical Center
- Saint Alphonsus Medical Center Ontario
Merit-based Incentive Payment System (MIPS)
- Final score
- 78.29 of 100
- Quality
- 52.53
- Promoting interoperability
- 100
- Improvement activities
- 40
- Cost
- 75.1
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 |
|---|---|---|---|---|
| I20070214000327 | ID | Practitioner - Physician Assistant | 2264434562 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PA644 | ID | MD | Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Idaho Surgical, LLC | Past |
Accepting new patients |
Interoperability endpoints
- nallen1737956@direct.trinity-health.org
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | PA644 | ID | Yes |
Addresses
Primary practice location
703 S Americana Blvd
Ste 120
Boise, ID 83702-5099
Mailing address
190 E Bannock St
Boise, ID 83712
Phone (208) 381-2222
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| PAD82 | Other | ID | BLUE CROSS MERIDIAN |
| 000010159170 | Other | ID | BLUE SHIELD MERIDIAN |
| 000010159171 | Other | ID | BLUE SHIELD BOISE |
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 Nov 10, 2012. 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.