Individual provider Active NPI

Michaela S McMahon

  • Physician Assistant
  • Boise, ID
National Provider Identifier
1508640855
Registry record updated Nov 10, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
6051 W Emerald St
Boise, ID 83704-8969
Phone
(208) 302-5150
Fax
(208) 302-5155
NPI assigned
Aug 18, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 10, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X Primary

Addresses

Primary practice location

6051 W Emerald St
Boise, ID 83704-8969

Mailing address

PO Box 190930
Boise, ID 83719-0930
Phone (208) 367-5170

Other practice location 1

1005 N 9th St Apt 11
Boise, ID 83702-4263
Phone (208) 859-3390

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
I20251223004762 ID Practitioner - Physician Assistant 7416442793 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2025
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Saint Alphonsus Regional Medical Center IncGroup PAC ID 3476462359, 672 clinicians

Practice addresses (Care Compare)

10583 W Lake Hazel Rd
Boise, ID 83709-6326
Phone (208) 302-5900

10717 W State St
Star, ID 83669-6046
Phone (208) 302-6300

11035 Karcher Rd
Nampa, ID 83651-8200
Phone (208) 302-2100

1150 N Sister Catherine Way
Nampa, ID 83687-3133
Phone (208) 302-7000

215 E Hawaii Ave
Nampa, ID 83686-6011

3025 W Cherry LN
Meridian, ID 83642-8531

6022 W Emerald St
Boise, ID 83704-8855
Phone (208) 367-4603

6094 W Emerald St
Boise, ID 83704-8855
Phone (208) 302-1000

757 E Wythe Creek CT
Suite 100
Kuna, ID 83634-5006
Phone (208) 302-6500

Hospital & facility affiliations

  • Saint Alphonsus Regional Medical Center Hospital, Boise, ID, CCN 130007

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Saint Alphonsus Medical Center- Ontario Inc CurrentSince Jan 1, 2026 Accepting new patients
Saint Alphonsus Regional Medical Center Inc CurrentSince Jan 1, 2026 Accepting new patients
Saint Alphonsus Medical Center- Ontario Inc CurrentSince Jan 1, 2026 Accepting new patients
Saint Alphonsus Regional Medical Center Inc CurrentSince Jan 1, 2026 Accepting new patients

Locations

6051 W Emerald St
Boise, ID 83704
Phone (208) 302-5100

910 NW 16th St
Ste 101
Fruitland, ID 83619
Phone (208) 452-8000

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

Organizations & group practices 5

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": "1692316800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1762732800000",
    "number": "1508640855",
    "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": "208-367-5170",
            "fax_number": "208-367-5180"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6051 W EMERALD ST",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837048969",
            "telephone_number": "208-302-5150",
            "fax_number": "208-302-5155"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1005 N 9th St Apt 11",
            "address_purpose": "LOCATION",
            "city": "Boise",
            "state": "ID",
            "postal_code": "837024263",
            "country_code": "US",
            "telephone_number": "208-859-3390",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MCMAHON",
        "first_name": "MICHAELA",
        "middle_name": "S",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-08-18",
        "last_updated": "2025-11-10",
        "certification_date": "2025-11-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boise, ID

Sources for this page

Verify at the official NPI Registry.