Individual provider Active NPI

David Wayne Hill, PA-C

  • Physician Assistant
  • Cascade, ID
National Provider Identifier
1750570693
Registry record updated Feb 22, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA-713 Issued in ID
Practice address
402 Lake Cascade Pkwy
Cascade, ID 83611-7702
Phone
(208) 382-4285
Fax
(208) 382-5081
NPI assigned
Oct 16, 2007
Last updated
Feb 22, 2021By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 22, 2021

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-713 ID Primary

Addresses

Primary practice location

402 Lake Cascade Pkwy
Cascade, ID 83611-7702

Mailing address

PO Box 1330
Cascade, ID 83611-1330
Phone (208) 382-4285

Other identifiers 1

IdentifierTypeStateIssuer
PA-713OtherIDIDAHO BOARD OF MEDICINE

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
I20080117000636 ID Practitioner - Physician Assistant 3870674641 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

402 Lake Cascade Pkwy
Cascade, ID 83611-7702
Phone (208) 382-4285

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Cascade Medical Center Hospital District Family Medicine CurrentSince Feb 24, 2020 Accepting new patients
Cascade Medical Center Hospital District CurrentSince Feb 24, 2020 Accepting new patients
Cep America, LLC CurrentSince Dec 1, 2024 Accepting new patients
Cep America LLC CurrentSince Dec 1, 2024 Accepting new patients
Pebble Creek Emergency Physicians PLLC Past Accepting new patients

Locations

1601 Cummins Dr
Ste D
Modesto, CA 95358
Phone (510) 350-2663

1055 N Curtis Rd
Boise, ID 83706
Phone (208) 367-2152

777 Hospital Way
Pocatello, ID 83201
Phone (208) 239-1000

Interoperability endpoints

  • Direct secure messaging: david.hill.1@15123.direct.athenahealth.com
  • Direct secure messaging: dhill814955@direct.ochin.org
  • Direct secure messaging: hdavidw259590@ahs.direct-ci.com

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 1

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": "1192492800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1613952000000",
    "number": "1750570693",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1330",
            "city": "CASCADE",
            "state": "ID",
            "postal_code": "836111330",
            "telephone_number": "208-382-4285",
            "fax_number": "208-382-5081"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "402 LAKE CASCADE PKWY",
            "city": "CASCADE",
            "state": "ID",
            "postal_code": "836117702",
            "telephone_number": "208-382-4285",
            "fax_number": "208-382-5081"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HILL",
        "first_name": "DAVID",
        "middle_name": "WAYNE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-10-16",
        "last_updated": "2021-02-22",
        "certification_date": "2021-02-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "ID",
            "license": "PA-713",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "IDAHO BOARD OF MEDICINE",
            "identifier": "PA-713",
            "state": "ID"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Cascade, ID

Sources for this page

Verify at the official NPI Registry.