Kristine P Kingery, PA-C

Individual provider Active NPI Physician Assistant · Middleton, ID

NPI 1679517155 · NPPES record last updated Oct 2, 2024

Key facts

NPI
1679517155
Entity type
Individual (NPI type 1)
Primary specialty
Physician Assistant 363A00000X
License
PA582 (ID)
Practice address
381 S Middleton Rd Ste B
Middleton, ID 83644-5369
Phone
(208) 585-6311
NPI assigned
Jun 15, 2006
Sex
Female
Sole proprietor
No

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 and National Provider Directory roles.

Hospital & facility affiliations 7

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

Medicare Care Compare profile

Specialty
Physician Assistant
Education
Other, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mountain View Hospital LLC (272 clinicians)

Practice addresses (Care Compare)

2325 Coronado St
Idaho Falls, ID 83404-7407
Phone (208) 557-2700

Hospital & facility affiliations

  • Horizon Home Health West Home health agency · Caldwell, ID · CCN 137135
  • West Valley Medical Center Hospital · Caldwell, ID · CCN 130014
  • Mountain View Hospital Hospital · Idaho Falls, ID · CCN 130065
  • St Luke'S Regional Medical Center Hospital · Boise, ID · CCN 130006
  • St Luke'S Nampa Medical Center Hospital · Nampa, ID · CCN 130071

Medicare participation

Medicare fee-for-service enrollment
Enrolled in ID
Eligible to order & refer
Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
I20051121000892 ID Practitioner - Physician Assistant 2668491465 Reassigns benefits to 2 organizations

National Provider Directory

Medicare enrollment (NPD)
Yes
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
PA582IDMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Mountain View Hospital LLC Past Accepting new patients
Hti Physician Services of Utah, Inc Past Accepting new patients
West Valley Medical Group Specialty Services LLC Past Accepting new patients
Caldwell Internal Medicine Professional Association Past Accepting new patients
Reed I. Ward, D.O., P.a. Family Medicine Past
since Jul 1, 2002
Accepting new patients

Interoperability endpoints

  • Direct secure messaging: kristine.kingery@hca3.eclinicaldirectplus.com

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA582 ID Yes

Addresses

Primary practice location

381 S Middleton Rd Ste B
Middleton, ID 83644-5369

Mailing address

PO Box 277976
Atlanta, GA 30384-7976

Other identifiers

IdentifierTypeStateIssuer
807305900MedicaidID

Electronic endpoints

TypeEndpointUseAffiliation
Direct Messaging Address kristine.kinger@hca3.eclinicaldirectplus.com

Other providers in Middleton, ID

All providers in Middleton, ID · Physician Assistant in Idaho

Sources for this page

Verify at the official NPI Registry.