Katelyn Cramer Wade, PA, RD

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA-2113 Issued in ID

Practice address

1906 S Vista Ave
Boise, ID 83705-3453

Phone

(208) 433-1114

NPI assigned

Jun 21, 2018

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

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

Specialty

Physician Assistant

Education

Other, 2021

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Idaho Skin Surgery Center PCGroup PAC ID 9537234299, 4 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

90.34 of 100Reported as group

Quality

84.63

Promoting interoperability

96

Improvement activities

40

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Idaho Skin Surgery Center, PC

  • Dermatology Physician
  • Boise, ID
  • NPI 1295908127
  Medicare reassignment Care Compare group
• Issc Fruitland

  • Dermatology Physician
  • Fruitland, ID
  • NPI 1568112688
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1529539200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1646611200000",
    "number": "1780178814",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1906 S VISTA AVE",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837053453"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1906 S VISTA AVE",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837053453",
            "telephone_number": "208-433-1114"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WADE",
        "first_name": "KATELYN",
        "middle_name": "CRAMER",
        "credential": "PA, RD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-06-21",
        "last_updated": "2022-03-07",
        "certification_date": "2022-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "ID",
            "license": "D-935",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "ID",
            "license": "PA-2113",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tin Vuong
• W Allen Rader, MD PC
• W Parker Lamm DC PA
• Emma Wade, LCSW
• Karla Marie Wade, M.A., L.P.C.
• Samantha Wade, RD
• Anant Wadhwa
• Thomas Gill Wadsworth, PHARM.D.
• Nautica Wager
• Jill Shelton Wagers, DMD

• Physician Assistant in Boise, ID
• Providers in Boise, ID by specialty
• Physician Assistant in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2022; 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.

Verify at the official NPI Registry.