Individual provider Active NPI

Scott Rose, PA-C

  • Physician Assistant
  • Nampa, ID
National Provider Identifier
1528762820
Registry record updated Mar 31, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
2299 Issued in ID
Practice address
4400 E Flamingo Ave Ste 200
Nampa, ID 83687-1128
Phone
(208) 302-2700
Fax
(208) 302-2725
NPI assigned
Mar 29, 2023
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 31, 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 2299 ID Primary

Addresses

Primary practice location

4400 E Flamingo Ave Ste 200
Nampa, ID 83687-1128

Mailing address

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

Other practice location 1

4971 W Overland Rd
Boise, ID 83705-2822
Phone (208) 472-5050

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
I20230517001843 ID Practitioner - Physician Assistant 4880050871 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

3025 W Cherry LN
Meridian, ID 83642-8531

4300 E Flamingo Ave
Nampa, ID 83687-3138
Phone (208) 205-1000

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
84.87 of 100Reported as group
Quality
77.29
Promoting interoperability
97
Improvement activities
40
Cost
74.78

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2299IDMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Saint Alphonsus Regional Medical Center Inc CurrentSince May 25, 2025 Accepting new patients
Alliance Medical Group, LLC Family Medicine CurrentSince May 15, 2023 Accepting new patients
Alliance Medical Group, LLC Family Medicine CurrentSince May 15, 2023 Accepting new patients
Saint Alphonsus Regional Medical Center Inc CurrentSince May 25, 2025 Accepting new patients
Alliance Medical Group, LLC Family Medicine Past Accepting new patients

Locations

4971 W Overland Rd
Boise, ID 83705
Phone (208) 472-5050

512 N 21st Ave
Caldwell, ID 83605
Phone (208) 809-2875

10482 W Carlton Bay Dr
Garden City, ID 83714
Phone (208) 454-9690

1623 S Wells Ave
Meridian, ID 83642
Phone (208) 489-1450

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

4400 E Flamingo Ave
Nampa, ID 83687
Phone (208) 288-4620

4400 E Flamingo Ave
Ste 200
Nampa, ID 83687
Phone (208) 302-2100

Interoperability endpoints

  • Direct secure messaging: scott.rose@phmg.eclinicaldirectplus.com
  • Direct secure messaging: srose4426677@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.

Hospital & facility affiliations 1

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": "1680048000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1743379200000",
    "number": "1528762820",
    "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": "4400 E FLAMINGO AVE STE 200",
            "city": "NAMPA",
            "state": "ID",
            "postal_code": "836871128",
            "telephone_number": "208-302-2700",
            "fax_number": "208-302-2725"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4971 W Overland Rd",
            "address_purpose": "LOCATION",
            "city": "Boise",
            "state": "ID",
            "postal_code": "837052822",
            "country_code": "US",
            "telephone_number": "208-472-5050",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ROSE",
        "first_name": "SCOTT",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-03-29",
        "last_updated": "2025-03-31",
        "certification_date": "2025-03-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "ID",
            "license": "2299",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Nampa, ID

Sources for this page

Verify at the official NPI Registry.