Individual provider Active NPI

Michele Miles, PA-C,MS

  • Physician Assistant
  • Emmett, ID
National Provider Identifier
1710011325
Registry record updated Apr 14, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
ID PA498 Issued in ID
Practice address
2001 E Quail Run Rd
Emmett, ID 83617-5059
Phone
(208) 365-7131
Fax
(208) 365-4464
NPI assigned
Mar 15, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 14, 2026

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 ID PA498 ID Primary

Addresses

Primary practice location

2001 E Quail Run Rd
Emmett, ID 83617-5059

Mailing address

PO Box 191050
Boise, ID 83719-1050
Phone (208) 955-6500

Other identifiers 1

IdentifierTypeStateIssuer
807782300MedicaidID

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
I20040927000670 ID Practitioner - Physician Assistant 5890764955 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science, Physician Assistant

State licenses

LicenseStateTypeSpecialty
ID PA498IDMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Direct Orthopedic Care LLC CurrentSince Dec 1, 2021 Accepting new patients
Orthopedic & Fracture Clinic PA Past Accepting new patients
Petrie White Family Medicine of Idaho PastSince Oct 21, 2015 Accepting new patients
Main Family Medical Past Accepting new patients

Locations

7979 W Rifleman St
Ste 110
Boise, ID 83704
Phone (208) 321-4000

3015 E Magic View Dr
Meridian, ID 83642
Phone (208) 321-4000

3015 E Magic View Dr
Ste 130
Meridian, ID 83642
Phone (208) 482-5567

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1173916800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1776124800000",
    "number": "1710011325",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 191050",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837191050",
            "telephone_number": "208-955-6500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2001 E QUAIL RUN RD",
            "city": "EMMETT",
            "state": "ID",
            "postal_code": "836175059",
            "telephone_number": "208-365-7131",
            "fax_number": "208-365-4464"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MILES",
        "first_name": "MICHELE",
        "name_prefix": "Ms.",
        "credential": "PA-C,MS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-15",
        "last_updated": "2026-04-14",
        "certification_date": "2026-04-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "ID",
            "license": "ID PA498",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "807782300",
            "state": "ID"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Emmett, ID

Sources for this page

Verify at the official NPI Registry.