Individual provider Active NPI

Samuel Thomas, PA-C

  • Physician Assistant
  • Boise, ID
National Provider Identifier
1497285688
Registry record updated Jul 11, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA2046 Issued in ID
Practice address
6165 W Emerald St
Boise, ID 83704-8613
Phone
(208) 302-3900
Fax
(208) 302-3955
NPI assigned
Jun 19, 2017
Last updated
Jul 11, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 11, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210518000577 ID Practitioner - Physician Assistant 5395002216 Reassigns benefits to 3 organizations

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
Post Acute Rehabilitation Physicians LLCGroup PAC ID 7214334614, 44 clinicians

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

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PA2046IDMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Direct Orthopedic Care LLC CurrentSince Dec 1, 2021 Accepting new patients
NW Wound Care Specialists PLLC CurrentSince Sep 18, 2025 Accepting new patients
Saint Alphonsus Regional Medical Center Inc Physician Assistant CurrentSince Jul 1, 2021 Accepting new patients
Saint Alphonsus Regional Medical Center Inc CurrentSince Jul 1, 2021 Accepting new patients
Rothman Orthopaedics of Florida,PLLC CurrentSince May 1, 2021 Accepting new patients

Locations

255 N Lakemont Ave
Ste 207
Winter Park, FL 32792
Phone (407) 852-5333

1055 N Curtis Rd
Boise, ID 83706
Phone (208) 367-2152

6165 W Emerald St
Boise, ID 83704
Phone (208) 302-3500

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

901 N Curtis Rd
Ste 501
Boise, ID 83706
Phone (208) 302-3900

1875 N Lakewood Dr
Fl 3
Coeur D Alene, ID 83814
Phone (509) 343-0250

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

3025 W Cherry Ln
Meridian, ID 83642
Phone (208) 302-6400

3025 W Cherry Ln
Ste B
Meridian, ID 83642
Phone (208) 302-6400

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

Interoperability endpoints

  • Direct secure messaging: sthomas1563986@direct.trinity-health.org

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 7

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": "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

Verify at the official NPI Registry.