Active NPI
Samuel Thomas, PA-C
- Physician Assistant
- Boise, ID
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- PA2046
- Practice address
- 6165 W Emerald St
Boise, ID 83704-8613 - Phone
- (208) 302-3900
- Fax
- (208) 302-3955
- NPI assigned
- Jun 19, 2017
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Surgical Physician Assistant | 363AS0400X | FL | ||
| Physician Assistant | 363A00000X | PA2046 | ID | Primary |
Addresses
Primary practice location
6165 W Emerald St
Boise, ID 83704-8613
Mailing address
PO Box 190930
Boise, ID 83719-0930
Phone (208) 302-9342
Other practice location 1
2501 N Orange Ave Ste 340
Orlando, FL 32804-4601
Phone (407) 894-8890
Other practice location 2
901 N Curtis Rd Ste 501
Boise, ID 83706-1343
Phone (208) 302-3900
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
Enrollment records 1
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
Practice addresses (Care Compare)
1055 N Curtis
Boise, ID 83706-1309
1055 N Curtis Rd
Boise, ID 83706-1309
Phone (208) 367-2121
3025 W Cherry LN
Meridian, ID 83642-8531
3550 W Americana Ter
Boise, ID 83706-4728
Phone (801) 215-9309
6165 W Emerald St
Boise, ID 83704-8613
Phone (208) 302-3500
Hospital & facility affiliations
- Saint Alphonsus Regional Medical Center
- St Luke'S Regional Medical Center
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PA2046 | ID | MD | Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Saint Alphonsus Regional Medical Center Inc | Physician Assistant | Current | Accepting new patients |
| Rothman Orthopaedics of Florida,PLLC | Current | Accepting new patients | |
| NW Wound Care Specialists PLLC | Current | Accepting new patients | |
| Direct Orthopedic Care LLC | Current | Accepting new patients | |
| Saint Alphonsus Regional Medical Center Inc | Current | Accepting new patients |
Locations
255 N Lakemont Ave
Ste 207
Winter Park, FL 32792
Phone (407) 852-5333
7979 W Rifleman St
Ste 110
Boise, ID 83704
Phone (208) 321-4000
6165 W Emerald St
Boise, ID 83704
Phone (208) 302-3500
901 N Curtis Rd
Ste 501
Boise, ID 83706
Phone (208) 302-3900
1055 N Curtis Rd
Boise, ID 83706
Phone (208) 367-2152
1875 N Lakewood Dr
Fl 3
Coeur D Alene, ID 83814
Phone (509) 343-0250
3340 E Goldstone Dr
Meridian, ID 83642
Phone (208) 302-9342
3015 E Magic View Dr
Meridian, ID 83642
Phone (208) 321-4000
3025 W Cherry Ln
Meridian, ID 83642
Phone (208) 302-6400
3015 E Magic View Dr
Ste 130
Meridian, ID 83642
Phone (208) 482-5567
3025 W Cherry Ln
Ste B
Meridian, ID 83642
Phone (208) 302-6400
Interoperability endpoints
- sthomas1563986@direct.trinity-health.org
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.
-
- Psychologist
- Boise, ID
- NPI 1649357716
Physician Assistant
-
- Physical Medicine & Rehabilitation Physician
- Lehi, UT
- NPI 1023781028
ID
-
- Orthopaedic Surgery Physician
- Boise, ID
- NPI 1356769434
-
- Psychiatric Hospital Unit
- Boise, ID
- NPI 1770687857
-
- Physical Medicine & Rehabilitation Physician
- Spokane Valley, WA
- NPI 1619762572
-
- Prosthetic/Orthotic Supplier
- Winter Park, FL
- NPI 1891371779
Hospital & facility affiliations 7
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Boise, ID
- NPI 1184155426
-
- General Acute Care Hospital
- Boise, ID
- NPI 1457414948
-
- Psychiatric Hospital Unit
- Boise, ID
- NPI 1770687857
-
- Family Medicine Physician
- Caldwell, ID
- NPI 1861676298
Hospital
-
- General Acute Care Hospital
- Boise, ID
- NPI 1992736649
-
- General Acute Care Hospital
- Boise, ID
- NPI 1770586794
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1497830400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1689033600000",
"number": "1497285688",
"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": "208-302-9342"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6165 W EMERALD ST",
"city": "BOISE",
"state": "ID",
"postal_code": "837048613",
"telephone_number": "208-302-3900",
"fax_number": "208-302-3955"
}
],
"practiceLocations": [
{
"address_1": "2501 N Orange Ave Ste 340",
"address_purpose": "LOCATION",
"city": "Orlando",
"state": "FL",
"postal_code": "328044601",
"country_code": "US",
"telephone_number": "407-894-8890",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "901 N Curtis Rd Ste 501",
"address_purpose": "LOCATION",
"city": "Boise",
"state": "ID",
"postal_code": "837061343",
"country_code": "US",
"telephone_number": "208-302-3900",
"fax_number": "208-302-3955",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "THOMAS",
"first_name": "SAMUEL",
"credential": "PA-C",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2017-06-19",
"last_updated": "2023-07-11",
"certification_date": "2023-07-11",
"status": "A"
},
"taxonomies": [
{
"code": "363AS0400X",
"taxonomy_group": "",
"desc": "Physician Assistant, Surgical",
"state": "FL",
"license": null,
"primary": false
},
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "ID",
"license": "PA2046",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Boise, ID
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 11, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.