Active NPI
Cheryl Ann Conlin, PA-C
- Physician Assistant
- Boise, ID
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- PA-1875
- Practice address
- 190 E Bannock St
Boise, ID 83712-6241 - Phone
- (208) 381-2094
- Fax
- (208) 381-1791
- NPI assigned
- Dec 1, 2016
- Last updated
- Jul 7, 2020
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 10166960-1206 | UT | |
| Physician Assistant | 363A00000X | 10166960-8906 | UT | |
| Physician Assistant | 363A00000X | PA-1875 | ID | Primary |
Addresses
Primary practice location
190 E Bannock St
Boise, ID 83712-6241
Mailing address
PO Box 1108
Corvallis, OR 97339-1108
Phone (805) 286-3826
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
Enrollment records 1
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
Practice addresses (Care Compare)
1210 NW 16TH St
Fruitland, ID 83619-2202
Phone (208) 381-2094
190 E Bannock St
Boise, ID 83712-6241
Phone (208) 381-2094
895 N 6TH St E
Mountain Home, ID 83647-2207
Phone (208) 381-2094
9850 St Lukes Dr
Nampa, ID 83687-7912
Phone (208) 505-2017
Hospital & facility affiliations
Merit-based Incentive Payment System (MIPS)
- Final score
- 93.94 of 100
- Quality
- 92.87
- Improvement activities
- 40
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PA-1875 | ID | MD | Physician Assistant |
| 10166960-8906 | UT | MD | Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| St Lukes Clinic-Treasure Valley LLC | Current | Accepting new patients | |
| Central Utah Radiology, PC | Past | Accepting new patients | |
| St Lukes Regional Medical Center | Past | Accepting new patients |
Locations
100 E Idaho St
Boise, ID 83712
Phone (208) 343-3223
190 E Bannock St
Boise, ID 83712
Phone (208) 381-2378
600 N Robbins Rd
Boise, ID 83702
Phone (208) 489-4444
610 W Hays St
Boise, ID 83702
Phone (208) 345-3530
701 E Parkcenter Blvd
Boise, ID 83706
Phone (208) 381-6400
3101 E State St
Eagle, ID 83616
Phone (208) 473-3100
1210 NW 16th St
Fruitland, ID 83619
Phone (208) 452-8600
3140 W Milano Dr
Ste 150
Meridian, ID 83646
Phone (208) 887-4775
3277 E Louise Dr
Ste 100
Meridian, ID 83642
Phone (208) 706-5217
520 S Eagle Rd
Meridian, ID 83642
Phone (208) 706-5000
895 N 6th E
Mtn Home, ID 83647
Phone (208) 580-2661
9850 W St Lukes Dr
Nampa, ID 83687
Phone (208) 205-7282
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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Diagnostic Radiology Physician
- Boise, ID
- NPI 1740216175
-
- Family Medicine Physician
- Boise, ID
- NPI 1326336058
-
dba St Lukes Meridian Medical Center
- General Acute Care Hospital
- Boise, ID
- NPI 1770586794
-
- Diagnostic Radiology Physician
- Nephi, UT
- NPI 1548261290
Hospital & facility affiliations 3
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
dba St Lukes Meridian Medical Center
- General Acute Care Hospital
- Boise, ID
- NPI 1770586794
-
dba St Lukes Nampa Medical Center
- General Acute Care Hospital
- Nampa, ID
- NPI 1831590660
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1480550400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1594080000000",
"number": "1770026270",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 1108",
"city": "CORVALLIS",
"state": "OR",
"postal_code": "973391108",
"telephone_number": "805-286-3826"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "190 E BANNOCK ST",
"city": "BOISE",
"state": "ID",
"postal_code": "837126241",
"telephone_number": "208-381-2094",
"fax_number": "208-381-1791"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CONLIN",
"first_name": "CHERYL",
"middle_name": "ANN",
"credential": "PA-C",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2016-12-01",
"last_updated": "2020-07-07",
"certification_date": "2020-07-07",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "UT",
"license": "10166960-1206",
"primary": false
},
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "UT",
"license": "10166960-8906",
"primary": false
},
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "ID",
"license": "PA-1875",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Boise, ID
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 7, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.