NPIMap

Individual provider Active NPI

Alexx Sliman, PA

  • Surgical Physician Assistant
  • Twin Falls, ID
National Provider Identifier
1275047409
Registry record updated Aug 1, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
License
PA-1640 Issued in ID
Practice address
775 Pole Line Rd W Ste 112
Twin Falls, ID 83301-5819
Phone
(208) 814-8200
NPI assigned
Nov 27, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 1, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Physician Assistant 363AS0400X 3472 TN
Surgical Physician Assistant 363AS0400X PA-1640 ID Primary

Addresses

Primary practice location

775 Pole Line Rd W Ste 112
Twin Falls, ID 83301-5819

Mailing address

190 E Bannock St
Boise, ID 83712-6241

Other practice location 1

744 Middle Creek Rd Ste 114
Sevierville, TN 37862-5036
Phone (865) 446-9575

Other practice location 2

425 Idaho St
Gooding, ID 83330-1258
Phone (208) 934-5900

Other identifiers 1

IdentifierTypeStateIssuer
Q033058MedicaidTN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN, ID2 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
I20180413000612 TN Practitioner - Physician Assistant 6901169531 Reassigns benefits to 1 organization
I20181213003131 ID Practitioner - Physician Assistant 6901169531 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
St Lukes Clinic LLCGroup PAC ID 1052217478, 313 clinicians

Practice addresses (Care Compare)

746 N College Rd
Twin Falls, ID 83301-3486

775 Pole Line Rd W
Twin Falls, ID 83301-5819

801 Pole Line Rd W
Twin Falls, ID 83301-5810

Hospital & facility affiliations

  • St Lukes Magic Valley Medical Center Hospital, Twin Falls, ID, CCN 130002
  • North Canyon Medical Center Hospital, Gooding, ID, CCN 131302
  • St Luke'S Jerome Hospital, Jerome, ID, CCN 131310
  • St Luke'S Regional Medical Center Hospital, Boise, ID, CCN 130006
  • Minidoka Memorial Hospital Hospital, Rupert, ID, CCN 131319

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
3472TNMDProfessional Counselor
PA-1640IDMDSurgical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Covenant Medical Group, Inc CurrentSince Nov 13, 2017 Accepting new patients
Covenant Medical Group, Inc. Family Medicine CurrentSince Nov 13, 2017 Accepting new patients
Associates in Family Practice Inc Family Medicine Current Accepting new patients
St Luke'S Magic Valley Regional Medical Center LTD Past Accepting new patients

Locations

425 Idaho St
Gooding, ID 83330
Phone (208) 934-5900

640 Frogs Lndg
Hagerman, ID 83332
Phone (208) 731-6241

1400 Centerpoint Blvd
Ste 202
Knoxville, TN 37932

Dept 888179
Knoxville, TN 37995

111 Clyde St
Loudon, TN 37774
Phone (865) 458-1554

744 Middle Creek Rd
Ste 114
Sevierville, TN 37862
Phone (865) 446-9575

Organizations & group practices 6

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.

Hospital & facility affiliations 6

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": "1511740800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1690848000000",
    "number": "1275047409",
    "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": "775 POLE LINE RD W STE 112",
            "city": "TWIN FALLS",
            "state": "ID",
            "postal_code": "833015819",
            "telephone_number": "208-814-8200"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "744 Middle Creek Rd Ste 114",
            "address_purpose": "LOCATION",
            "city": "Sevierville",
            "state": "TN",
            "postal_code": "378625036",
            "country_code": "US",
            "telephone_number": "865-446-9575",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "425 Idaho St",
            "address_purpose": "LOCATION",
            "city": "Gooding",
            "state": "ID",
            "postal_code": "833301258",
            "country_code": "US",
            "telephone_number": "208-934-5900",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SLIMAN",
        "first_name": "ALEXX",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-11-27",
        "last_updated": "2023-08-01",
        "certification_date": "2023-08-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "TN",
            "license": "3472",
            "primary": false
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "ID",
            "license": "PA-1640",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "Q033058",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Twin Falls, ID

Sources for this page

Verify at the official NPI Registry.