NPIMap

Individual provider Active NPI

Scott D Schrader, P.A.

  • Physician Assistant
  • Twin Falls, ID
National Provider Identifier
1740223148
Registry record updated Dec 31, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA-271 Issued in ID
Practice address
650 Addison Ave W
Twin Falls, ID 83301-5444
Phone
(208) 732-3429
Fax
(208) 732-3220
NPI assigned
Jun 14, 2006
Last updated
Dec 31, 2009By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 31, 2009

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 PA-271 ID Primary

Addresses

Primary practice location

650 Addison Ave W
Twin Falls, ID 83301-5444

Mailing address

PO Box 1657
Twin Falls, ID 83303-1657
Phone (208) 734-3356

Other identifiers 1

IdentifierTypeStateIssuer
805592000MedicaidID

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ID
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040710000434 ID Practitioner - Physician Assistant 8224016787 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Dandg Medical Associates PLLCGroup PAC ID 6709140510, 16 clinicians

Practice addresses (Care Compare)

1430 W Ustick Rd
Suite 100
Meridian, ID 83646-7734
Phone (208) 286-8670

200 W Beech St
Caldwell, ID 83605-5692
Phone (208) 459-3335

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
89.58 of 100Reported as individual
Quality
100
Promoting interoperability
92
Improvement activities
40
Cost
38.59

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PA-271IDMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
St Lukes Clinic-Treasure Valley LLC CurrentSince Apr 1, 2018 Accepting new patients
St Luke's Magic Valley Regional Medical Center LTD Past Accepting new patients
Surgical Associates of Southern Id PastSince Jun 7, 2004 Accepting new patients
Gooding County Hospital District Past Accepting new patients
Magic Valley Regional Medical Center Past Accepting new patients

Locations

610 W Hays St
Boise, ID 83702
Phone (208) 345-3530

Interoperability endpoints

  • Direct secure messaging: sschrader32756@direct.slhs.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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 8

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": "1150243200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1262217600000",
    "number": "1740223148",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1657",
            "city": "TWIN FALLS",
            "state": "ID",
            "postal_code": "833031657",
            "telephone_number": "208-734-3356",
            "fax_number": "208-733-9463"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "650 ADDISON AVE W",
            "city": "TWIN FALLS",
            "state": "ID",
            "postal_code": "833015444",
            "telephone_number": "208-732-3429",
            "fax_number": "208-732-3220"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCHRADER",
        "first_name": "SCOTT",
        "middle_name": "D",
        "credential": "P.A.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-06-14",
        "last_updated": "2009-12-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "ID",
            "license": "PA-271",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "805592000",
            "state": "ID"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Twin Falls, ID

Sources for this page

Verify at the official NPI Registry.