NPIMap

Individual provider Active NPI

Mitch T Robinson, PA-C

  • Physician Assistant
  • Burley, ID
National Provider Identifier
1245581487
Registry record updated Sep 27, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA-1001 Issued in ID
Practice address
1501 Hiland Ave Ste C
Burley, ID 83318-2682
Phone
(208) 677-6080
Fax
(208) 677-6090
NPI assigned
Sep 27, 2012
Last updated
Sep 27, 2012By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 27, 2012

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-1001 ID Primary

Addresses

Primary practice location

1501 Hiland Ave Ste C
Burley, ID 83318-2682

Mailing address

1501 Hiland Ave Ste C
Burley, ID 83318-2682
Phone (208) 677-6080

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ID, UT2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20121228000006 ID Practitioner - Physician Assistant 9638322613 Reassigns benefits to 2 organizations
I20230718001551 UT Practitioner - Physician Assistant 9638322613 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
North Canyon Medical Center IncGroup PAC ID 0941371439, shared by 7 NPIs, 73 clinicians
Ihc Health Services IncGroup PAC ID 1850209420, 3,948 clinicians

Practice addresses (Care Compare)

267 N Canyon Dr
Gooding, ID 83330-5500
Phone (208) 934-4433

5373 S Green St
Suite 400
Murray, UT 84123-4740
Phone (866) 415-6556

700 S Hwy 99
Suite 3
Fillmore, UT 84631-5137
Phone (801) 357-4600

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PA-1001IDMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Ihc Health Services, Inc. CurrentSince Oct 27, 2012 Accepting new patients
North Canyon Medical Center, Inc. CurrentSince Aug 31, 2019 Accepting new patients
Ihc Health Services Inc CurrentSince Jun 5, 2023 Accepting new patients
Ihc Health Services Inc CurrentSince Oct 27, 2012 Accepting new patients
North Canyon Medical Center, Inc. CurrentSince Aug 31, 2019 Accepting new patients
Ihc Health Services Inc Past Accepting new patients
Inland Cardiology Associates, P.S. Past Accepting new patients
St Luke's Magic Valley Regional Medical Center LTD Past Accepting new patients

Locations

1501 Hiland Ave
Burley, ID 83318
Phone (208) 678-4444

1501 Hiland Ave
Ste C
Burley, ID 83318
Phone (208) 677-6080

267 N Canyon Dr
Gooding, ID 83330
Phone (208) 934-4433

491 Heritage Dr
Jerome, ID 83338
Phone (208) 644-7500

2167 Village Park Ave
Twin Falls, ID 83301
Phone (208) 735-3728

700 S Highway 99
Ste 3
Fillmore, UT 84631
Phone (435) 743-5555

5373 S Green St
Ste 400
Salt Lake City, UT 84123
Phone (801) 442-2615

1380 E Medical Center Dr
#P
St George, UT 84790
Phone (435) 251-2355

Organizations & group practices 11

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 2

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": "1348704000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1348704000000",
    "number": "1245581487",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1501 HILAND AVE STE C",
            "city": "BURLEY",
            "state": "ID",
            "postal_code": "833182682",
            "telephone_number": "208-677-6080",
            "fax_number": "208-677-6090"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1501 HILAND AVE STE C",
            "city": "BURLEY",
            "state": "ID",
            "postal_code": "833182682",
            "telephone_number": "208-677-6080",
            "fax_number": "208-677-6090"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROBINSON",
        "first_name": "MITCH",
        "middle_name": "T",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-09-27",
        "last_updated": "2012-09-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "ID",
            "license": "PA-1001",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Burley, ID

Sources for this page

Verify at the official NPI Registry.