NPIMap

Individual provider Active NPI

Alex P Casebolt, PA

  • Physician Assistant
  • Boise, ID
National Provider Identifier
1346283363
Registry record updated May 28, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA300 Issued in ID
Practice address
6051 W Emerald St
Boise, ID 83704-8969
Phone
(208) 302-5150
Fax
(208) 302-5155
NPI assigned
Jun 14, 2006
Last updated
May 28, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 28, 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 PA300 ID Primary

Addresses

Primary practice location

6051 W Emerald St
Boise, ID 83704-8969

Mailing address

PO Box 190930
Boise, ID 83719-0930
Phone (208) 367-5170

Other practice location 1

8800 W Emerald St Ste 196
Boise, ID 83704-8205
Phone (208) 375-1105

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
I20070601000056 ID Practitioner - Physician Assistant 6103924980 Reassigns benefits to 5 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Momentum Medical Group of Idaho LLCGroup PAC ID 2668824608, 8 clinicians
Core Medicine Idaho LLCGroup PAC ID 8921441163, 4 clinicians

Practice addresses (Care Compare)

10583 W Lake Hazel Rd
Boise, ID 83709-6326
Phone (208) 302-5900

11035 Karcher Rd
Nampa, ID 83651-8200
Phone (208) 302-2100

1150 N Sister Catherine Way
Nampa, ID 83687-3133
Phone (208) 302-7000

1281 E Iron Eagle Dr
Eagle, ID 83616-6599
Phone (208) 855-0880

3025 W Cherry LN
Meridian, ID 83642-8531

4605 Enterprise Way
Suite 101
Caldwell, ID 83605-6889
Phone (208) 508-0345

757 E Wythe Creek CT
Suite 100
Kuna, ID 83634-5006
Phone (208) 302-6500

867 S Vanguard Way
Meridian, ID 83642-7552
Phone (208) 302-7950

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PA300IDMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Saint Alphonsus Medical Center- Ontario Inc CurrentSince Jul 1, 2024 Accepting new patients
Direct Orthopedic Care LLC CurrentSince Oct 1, 2020 Accepting new patients
Saint Alphonsus Medical Center- Ontario Inc CurrentSince Jul 1, 2024 Accepting new patients
Saint Alphonsus Regional Medical Center Inc CurrentSince Jul 1, 2024 Accepting new patients
Durham Family Medicine, PLLC PastSince Sep 5, 2023 Accepting new patients
Treasure Valley Occupational Medicine PastSince Jan 1, 2020 Accepting new patients
Boise Radiology Group PLLC Past Accepting new patients
Saint Alphonsus Regional Medical Center Inc Physician Assistant Past Accepting new patients

Locations

7979 W Rifleman St
Ste 110
Boise, ID 83704
Phone (208) 321-4000

315 E Elm St
Ste 100
Caldwell, ID 83605
Phone (208) 302-7100

910 NW 16th St
Ste 101
Fruitland, ID 83619
Phone (208) 452-8000

3015 E Magic View Dr
Ste 130
Meridian, ID 83642
Phone (208) 482-5567

3340 E Goldstone Dr
Meridian, ID 83642
Phone (208) 302-9342

Interoperability endpoints

  • Direct secure messaging: acasebolt3386835@direct.trinity-health.org
  • FHIR API: https://fhir4.healow.com/fhir/r4/JIBDDD

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 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": "1150243200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1716854400000",
    "number": "1346283363",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 190930",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837190930",
            "telephone_number": "208-367-5170",
            "fax_number": "208-367-5180"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6051 W EMERALD ST",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837048969",
            "telephone_number": "208-302-5150",
            "fax_number": "208-302-5155"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "8800 W Emerald St Ste 196",
            "address_purpose": "LOCATION",
            "city": "Boise",
            "state": "ID",
            "postal_code": "837048205",
            "country_code": "US",
            "telephone_number": "208-375-1105",
            "fax_number": "208-377-7707",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CASEBOLT",
        "first_name": "ALEX",
        "middle_name": "P",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-14",
        "last_updated": "2024-05-28",
        "certification_date": "2024-05-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "ID",
            "license": "PA300",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boise, ID

Sources for this page

Verify at the official NPI Registry.