Individual provider Active NPI

Alan E Crandall, PA-C

  • Physician Assistant
  • Blackfoot, ID
National Provider Identifier
1770002974
Registry record updated Oct 21, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA-1498 Issued in ID
Practice address
98 Poplar St
Blackfoot, ID 83221-1758
Phone
(208) 785-4100
NPI assigned
Sep 19, 2017
Last updated
Oct 21, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 21, 2025

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-1498 ID Primary

Addresses

Primary practice location

98 Poplar St
Blackfoot, ID 83221-1758

Mailing address

740 S Woodruff Ave
Idaho Falls, ID 83401-5285
Phone (208) 542-9111

Other practice location 1

740 S Woodruff Ave
Idaho Falls, ID 83401-5285
Phone (208) 542-9111

Other practice location 2

6165 W Emerald St
Boise, ID 83704-8613
Phone (208) 302-3900

Other identifiers 2

IdentifierTypeStateIssuer
PA-1498OtherIDSTATE
CS46489OtherIDSTATE

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
I20171117001987 ID Practitioner - Physician Assistant 6103182563 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
BMH IncGroup PAC ID 8426149758, 137 clinicians

Practice addresses (Care Compare)

1055 N Curtis Rd
Boise, ID 83706-1309
Phone (208) 367-2121

3025 W Cherry LN
Meridian, ID 83642-8531

315 W Idaho St
Blackfoot, ID 83221-1711
Phone (208) 782-3990

4742 Yellowstone Ave
Pocatello, ID 83202-2336
Phone (208) 251-0316

4750 Yellowstone Ave
Pocatello, ID 83202-2336
Phone (208) 233-1720

850 Yellowstone Ave
Pocatello, ID 83201-4415
Phone (208) 239-8065

98 Poplar St
Blackfoot, ID 83221-1758
Phone (208) 785-4100

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PA-1498IDMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
BMH, Inc. CurrentSince Oct 17, 2017 Accepting new patients
Urgent Care Associates PLLC Current Accepting new patients
Saint Alphonsus Regional Medical Center Inc Physician Assistant Current Accepting new patients
Saint Alphonsus Regional Medical Center Inc CurrentSince Nov 1, 2025 Accepting new patients
Sterling Provider Group CurrentSince Aug 1, 2020 Accepting new patients
BMH Inc CurrentSince Oct 17, 2017 Accepting new patients
BMH, Inc CurrentSince Oct 17, 2017 Accepting new patients
Saint Alphonsus Regional Medical Center Inc CurrentSince Nov 1, 2025 Accepting new patients
BMH, Inc. Past Accepting new patients
BMH, Inc. Past Accepting new patients
BMH, Inc. Past Accepting new patients
BMH Inc. Past Accepting new patients

Locations

3456 E 17th St
Ste 125
Ammon, ID 83406
Phone (208) 529-2828

1350 Parkway Dr
Ste A
Blackfoot, ID 83221

315 W Idaho St
Blackfoot, ID 83221
Phone (208) 782-3990

98 Poplar St
Blackfoot, ID 83221
Phone (208) 782-3763

10965 W Overland Rd
Boise, ID 83709
Phone (208) 900-9901

1129 S Broadway Ave
Boise, ID 83706
Phone (208) 795-9790

6165 W Emerald St
Boise, ID 83704
Phone (208) 302-3500

6965 N Glenwood St
Boise, ID 83714
Phone (208) 853-3000

1404 Pomerelle Ave
Ste A1
Burley, ID 83318
Phone (208) 878-8783

5605 Northside Xing
Chubbuck, ID 83202
Phone (208) 547-5062

507 S Main St
Hailey, ID 83333
Phone (208) 788-0061

3302 Valencia Dr
Ste 120
Idaho Falls, ID 83404
Phone (208) 535-3635

3302 Valencia Dr
Ste 201
Idaho Falls, ID 83404
Phone (208) 524-9400

7017 Daisy Ln
Idaho Falls, ID 83402
Phone (208) 534-5878

740 S Woodruff Ave
Idaho Falls, ID 83401
Phone (208) 542-9111

2201 Thain Grade
Lewiston, ID 83501
Phone (208) 717-3100

3025 W Cherry Ln
Ste B
Meridian, ID 83642
Phone (208) 302-6400

3185 E Ustick Rd
Meridian, ID 83646
Phone (208) 296-7100

1610 Caldwell Blvd
Nampa, ID 83651
Phone (208) 207-8500

4750 Yellowstone Ave
Ste A
Pocatello, ID 83202
Phone (208) 233-1720

850 Yellowstone Ave
Ste A
Pocatello, ID 83201
Phone (208) 239-8065

130 W Main St
Rexburg, ID 83440
Phone (208) 356-8818

275 W Locust St
Ste A
Shelley, ID 83274

Interoperability endpoints

  • Direct secure messaging: acrandall4603835@direct.trinity-health.org
  • Direct secure messaging: alancrandall@bmh.medalliesdirect.net

Organizations & group practices 13

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.

View all 13

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": "1505779200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1761004800000",
    "number": "1770002974",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "740 S WOODRUFF AVE",
            "city": "IDAHO FALLS",
            "state": "ID",
            "postal_code": "834015285",
            "telephone_number": "208-542-9111",
            "fax_number": "208-542-9114"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "98 POPLAR ST",
            "city": "BLACKFOOT",
            "state": "ID",
            "postal_code": "832211758",
            "telephone_number": "208-785-4100"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "740 S Woodruff Ave",
            "address_purpose": "LOCATION",
            "city": "Idaho Falls",
            "state": "ID",
            "postal_code": "834015285",
            "country_code": "US",
            "telephone_number": "208-542-9111",
            "fax_number": "208-542-9114",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "6165 W Emerald St",
            "address_purpose": "LOCATION",
            "city": "Boise",
            "state": "ID",
            "postal_code": "837048613",
            "country_code": "US",
            "telephone_number": "208-302-3900",
            "fax_number": "208-302-3955",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CRANDALL",
        "first_name": "ALAN",
        "middle_name": "E",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-09-19",
        "last_updated": "2025-10-21",
        "certification_date": "2025-10-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "ID",
            "license": "PA-1498",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE",
            "identifier": "PA-1498",
            "state": "ID"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE",
            "identifier": "CS46489",
            "state": "ID"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Blackfoot, ID

Sources for this page

Verify at the official NPI Registry.