Active NPI
Traci H Permenter, PA-C
- Physician Assistant
- Boise, ID
National Provider Identifier
1588227656
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- PA-1717
- Practice address
- 303 N Allumbaugh St
Boise, ID 83704-9208 - Phone
- (208) 888-5848
- NPI assigned
- Apr 15, 2019
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | PA-1717 | ID | Primary |
Addresses
Primary practice location
303 N Allumbaugh St
Boise, ID 83704-9208
Mailing address
PO Box 16303
Boise, ID 83715-6303
Phone (713) 858-1040
Other practice location 1
943 N Linder Rd Ste 103
Kuna, ID 83634-3395
Phone (208) 922-3355
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in TX
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Kuna Healthcare Clinic, PLLC | Past | Accepting new patients | |
| Jones Foot & Ankle LLC | Past | Accepting new patients |
Organizations & group practices 3
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.
-
- Emergency Medicine Physician
- Austin, TX
- NPI 1649669672
-
- Foot & Ankle Surgery Podiatrist
- Hailey, ID
- NPI 1528837374
-
- Nurse Practitioner
- Kuna, ID
- NPI 1114489788
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1555286400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1605657600000",
"number": "1588227656",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 16303",
"city": "BOISE",
"state": "ID",
"postal_code": "837156303",
"telephone_number": "713-858-1040"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "303 N ALLUMBAUGH ST",
"city": "BOISE",
"state": "ID",
"postal_code": "837049208",
"telephone_number": "208-888-5848"
}
],
"practiceLocations": [
{
"address_1": "943 N Linder Rd Ste 103",
"address_purpose": "LOCATION",
"city": "Kuna",
"state": "ID",
"postal_code": "836343395",
"country_code": "US",
"telephone_number": "208-922-3355",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "PERMENTER",
"first_name": "TRACI",
"middle_name": "H",
"credential": "PA-C",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2019-04-15",
"last_updated": "2020-11-18",
"certification_date": "2020-11-18",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "ID",
"license": "PA-1717",
"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 Nov 18, 2020; 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.