Individual provider Active NPI

Phillip Marlowe, PA-C

  • Physician Assistant
  • Idaho Falls, ID
National Provider Identifier
1760044424
Registry record updated Jun 8, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA-1886 Issued in ID
Practice address
3422 S 15TH E
Idaho Falls, ID 83404-8262
Phone
(208) 529-9292
NPI assigned
Jul 2, 2019
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 8, 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-1886 ID Primary

Addresses

Primary practice location

3422 S 15TH E
Idaho Falls, ID 83404-8262

Mailing address

3422 S 15TH E
Idaho Falls, ID 83404-8262
Phone (208) 529-9292

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
I20200611003373 ID Practitioner - Physician Assistant 6305268723 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Wallace C BakerGroup PAC ID 0446208904, 6 clinicians

Practice addresses (Care Compare)

1880 John Adams Pkwy
Idaho Falls, ID 83401-4315
Phone (208) 524-6633

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
84.7 of 100Reported as group
Quality
88.89
Improvement activities
40
Cost
63.83

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PA-1886IDMDPhysician Assistant

Organizations & group practices 2

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": "1562025600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1623110400000",
    "number": "1760044424",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3422 S 15TH E",
            "city": "IDAHO FALLS",
            "state": "ID",
            "postal_code": "834048262",
            "telephone_number": "208-529-9292"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3422 S 15TH E",
            "city": "IDAHO FALLS",
            "state": "ID",
            "postal_code": "834048262",
            "telephone_number": "208-529-9292"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARLOWE",
        "first_name": "PHILLIP",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-07-02",
        "last_updated": "2021-06-08",
        "certification_date": "2021-06-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "ID",
            "license": "PA-1886",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Idaho Falls, ID

Sources for this page

Verify at the official NPI Registry.