NPIMap

Individual provider Active NPI

Sorcha M Cusack, PA-C

  • Medical Physician Assistant
  • Boise, ID
National Provider Identifier
1396071056
Registry record updated Jan 5, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
PA825 Issued in ID
Practice address
300 E Jefferson St
Ste 300
Boise, ID 83712-6246
Phone
(208) 381-4000
NPI assigned
Oct 29, 2009
Last updated
Jan 5, 2012By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 5, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X PA825 ID Primary

Addresses

Primary practice location

300 E Jefferson St
Ste 300
Boise, ID 83712-6246

Mailing address

190 E Bannock St
Boise, ID 83712-6241
Phone (208) 732-3400

Other identifiers 1

IdentifierTypeStateIssuer
PA825OtherIDSTATE LICENSE

Other names 1

  • Sorcha M Yingst Former name

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
I20091203000461 ID Practitioner - Physician Assistant 6204975238 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
St Lukes Clinic-Treasure Valley LLCGroup PAC ID 4981878402, 1,155 clinicians

Practice addresses (Care Compare)

608 W Hays St
Boise, ID 83702-5511
Phone (208) 381-5970

610 W Hays St
Boise, ID 83702-5511
Phone (208) 381-5970

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PA825IDMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
St Lukes Clinic-Treasure Valley LLC CurrentSince Apr 1, 2012 Accepting new patients
St Lukes Regional Medical Center Past Accepting new patients
St Lukes Regional Medical Center Past Accepting new patients
St Luke's Magic Valley Regional Medical Center LTD Past Accepting new patients

Locations

190 E Bannock St
Boise, ID 83712
Phone (208) 381-2378

610 W Hays St
Boise, ID 83702
Phone (208) 345-3530

1000 E Park Blvd
Ste 120
Boise, ID 83712
Phone (208) 381-4100

300 E Jefferson St
Ste 300
Boise, ID 83712
Phone (208) 381-4100

520 S Eagle Rd
Meridian, ID 83642
Phone (208) 706-5000

Interoperability endpoints

  • Direct secure messaging: scusack5943@direct.slhs.org

Organizations & group practices 4

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 3

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": "1256774400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1325721600000",
    "number": "1396071056",
    "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",
            "telephone_number": "208-732-3400",
            "fax_number": "208-732-3300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 E JEFFERSON ST",
            "address_2": "STE 300",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837126246",
            "telephone_number": "208-381-4000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CUSACK",
        "first_name": "SORCHA",
        "middle_name": "M",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-10-29",
        "last_updated": "2012-01-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "ID",
            "license": "PA825",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "PA825",
            "state": "ID"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SORCHA",
            "last_name": "YINGST",
            "middle_name": "M",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Boise, ID

Sources for this page

Verify at the official NPI Registry.