Evan Dayne Ivie, PA

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA-1265 Issued in ID

Practice address

3456 E 17TH St Ste 190
Ammon, ID 83406-6749

Phone

(208) 524-2222

Fax

(855) 999-9242

NPI assigned

Oct 15, 2014

Last updated

Sep 3, 2025By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

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

Specialty

Physician Assistant

Education

Other, 2014

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Simpson Dermcare and Family Medicine PLLCGroup PAC ID 1355656307, 6 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

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.

• Simpson Dermcare and Family Medicine PLLC

  • Family Medicine Physician
  • Idaho Falls, ID
  • NPI 1174919534
  Medicare reassignment Care Compare group
• Mountain View Hospital LLC

  • General Acute Care Hospital
  • Idaho Falls, ID
  • NPI 1669462362
  Medicare reassignment NPD
• New Dawn Counseling, LLC

  • Clinical Social Worker
  • Idaho Falls, ID
  • NPI 1912182163
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1413331200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1756857600000",
    "number": "1558765891",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3456 E 17TH ST STE 190",
            "city": "AMMON",
            "state": "ID",
            "postal_code": "834066749",
            "telephone_number": "208-524-2222",
            "fax_number": "855-999-9242"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3456 E 17TH ST STE 190",
            "city": "AMMON",
            "state": "ID",
            "postal_code": "834066749",
            "telephone_number": "208-524-2222",
            "fax_number": "855-999-9242"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "IVIE",
        "first_name": "EVAN",
        "middle_name": "DAYNE",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-10-15",
        "last_updated": "2025-09-03",
        "certification_date": "2025-09-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "ID",
            "license": "PA-1265",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1174919534",
            "state": "ID"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "473675862",
            "state": "ID"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Idaho in Home Care
• Idaho Psychiatric Institute
• Idaho Vision Development Center PLLC
• Illuminations Counseling, LLC
• Maria Saldate Irwin
• James Oral and Maxillofacial Surgery PLLC
• Keri Sue James, M. A., CCC-SLP
• Theodore James, DDS
• Christopher James Jankowski
• Crista Ann Jardine, PTA

• Physician Assistant in Ammon, ID
• Providers in Ammon, ID by specialty
• Physician Assistant in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 3, 2025; 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.

Verify at the official NPI Registry.