NPIMap

Individual provider Active NPI

Daniel Brian McConnell Jr., MSPA

  • Medical Physician Assistant
  • Nampa, ID
National Provider Identifier
1376888735
Registry record updated Jan 31, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
PA-2063 Issued in ID
Practice address
4301 Garrity Blvd Ste 103
Nampa, ID 83687-9222
Phone
(714) 595-4110
NPI assigned
Dec 11, 2012
Last updated
Jan 31, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 31, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X PA22731 CA
Medical Physician Assistant 363AM0700X PA-2063 ID Primary
Surgical Physician Assistant 363AS0400X PA22731 CA

Addresses

Primary practice location

4301 Garrity Blvd Ste 103
Nampa, ID 83687-9222

Mailing address

4301 Garrity Blvd Ste 103
Nampa, ID 83687-9222
Phone (714) 595-4110

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
I20210928003634 ID Practitioner - Physician Assistant 7618299900 Reassigns benefits to 4 organizations

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
Dandg Medical Associates PLLCGroup PAC ID 6709140510, 16 clinicians

Practice addresses (Care Compare)

1127 Caldwell Blvd
Nampa, ID 83651-1701
Phone (208) 465-4935

1200 E 6TH
Mountain Home, ID 83647-3241
Phone (208) 286-8670

12385 Amorica St
Caldwell, ID 83607-5840
Phone (208) 286-8670

1430 W Ustick Rd
Suite 100
Meridian, ID 83646-7734
Phone (208) 286-8670

200 W Beech St
Caldwell, ID 83605-5692
Phone (208) 459-3335

404 N Horton St
Nampa, ID 83651-6541
Phone (208) 286-8670

6280 N Fox Run Way
Meridian, ID 83646-6791
Phone (208) 286-8670

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PA22731CAMDSurgical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Senior Doc Id Medical, PC CurrentSince Aug 1, 2024 Accepting new patients
Woundpro Technologies Current Accepting new patients
Straightway Health PLLC Surgical Current Accepting new patients
Geiss Med Hospice Id LLC PastSince Mar 15, 2022 Accepting new patients

Locations

2592 N Santiago Blvd
Orange, CA 92867
Phone (714) 577-2271

1430 W Ustick Rd
Ste 100
Meridian, ID 83646

4301 Garrity Blvd
Ste 103
Nampa, ID 83687
Phone (208) 463-0700

Ownership & related parties

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Geiss Med Hospice Id LLCNampa, ID, CCN 131593 Hospice W-2 Managing Employee (100%) Mar 15, 2022

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Organizations & group practices 7

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 14

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 14

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1355184000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1738281600000",
    "number": "1376888735",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4301 GARRITY BLVD STE 103",
            "city": "NAMPA",
            "state": "ID",
            "postal_code": "836879222",
            "telephone_number": "714-595-4110"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4301 GARRITY BLVD STE 103",
            "city": "NAMPA",
            "state": "ID",
            "postal_code": "836879222",
            "telephone_number": "714-595-4110"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCCONNELL",
        "first_name": "DANIEL",
        "middle_name": "BRIAN",
        "name_prefix": "Mr.",
        "name_suffix": "Jr.",
        "credential": "MSPA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-12-11",
        "last_updated": "2025-01-31",
        "certification_date": "2025-01-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "CA",
            "license": "PA22731",
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "ID",
            "license": "PA-2063",
            "primary": true
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "CA",
            "license": "PA22731",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Nampa, ID

Sources for this page

Verify at the official NPI Registry.