Individual provider Active NPI

Nathan Wheatley

  • Medical Physician Assistant
  • Coeur D Alene, ID
National Provider Identifier
1407307259
Registry record updated Oct 17, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
PA-1417 Issued in ID
Practice address
1090 W Park PL
Coeur D Alene, ID 83814-2785
Phone
(208) 292-0292
Fax
(208) 292-0705
NPI assigned
Oct 17, 2016
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 17, 2016

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 PA-1417 ID Primary

Addresses

Primary practice location

1090 W Park PL
Coeur D Alene, ID 83814-2785

Mailing address

PO Box 3648
Coeur D Alene, ID 83816-2522

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ID
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170203001199 ID Practitioner - Physician Assistant 5890078539 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Meza Post Acute and Long Term Care PLLCGroup PAC ID 4981028503, 26 clinicians

Practice addresses (Care Compare)

1605 N Catherine St
Post Falls, ID 83854-7237
Phone (208) 773-6145

2100 E Sherman Ave
Coeur D Alene, ID 83814-5335
Phone (208) 215-7166

2340 W Seltice Way
Coeur D Alene, ID 83814-8989
Phone (208) 819-4970

3400 E Fernan Hill Rd
Coeur D Alene, ID 83814-7588
Phone (208) 819-4970

3989 N Player Dr
Coeur D Alene, ID 83815-8000
Phone (208) 292-4163

632 N 21St St
Coeur D Alene, ID 83814-5510
Phone (208) 665-0580

824 N 23Rd St
Coeur D Alene, ID 83814-5909
Phone (208) 964-4545

840 E Dalton Ave
Coeur D Alene, ID 83815-9338
Phone (208) 665-2100

Hospital & facility affiliations

  • Reliant Healthcare, Inc Home health agency, Coeur D'Alene, ID, CCN 137126
  • Ahc Home Health of Coeur D Alene LLC Home health agency, Coeur D'Alene, ID, CCN 137130
  • Hospice of North Idaho Hospice, Coeur D Alene, ID, CCN 131504
  • Auburn Crest Hospice Hospice, Coeur D'Alene, ID, CCN 131559
  • Kootenai Health Hospital, Coeur D'Alene, ID, CCN 130049

Merit-based Incentive Payment System (MIPS)

Final score
86.65 of 100Reported as apm
Quality
89.26
Promoting interoperability
69.9
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PA-1417IDMDMedical Physician Assistant

Organizations & group practices 3

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 5

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": "1476662400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1476662400000",
    "number": "1407307259",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3648",
            "city": "COEUR D ALENE",
            "state": "ID",
            "postal_code": "838162522"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1090 W PARK PL",
            "city": "COEUR D ALENE",
            "state": "ID",
            "postal_code": "838142785",
            "telephone_number": "208-292-0292",
            "fax_number": "208-292-0705"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WHEATLEY",
        "first_name": "NATHAN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-10-17",
        "last_updated": "2016-10-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "ID",
            "license": "PA-1417",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Coeur D Alene, ID

Sources for this page

Verify at the official NPI Registry.