William Joseph Short, PAC

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA1027 Issued in ID

Practice address

1019 W Sanetta St
Nampa, ID 83651-5047

Phone

(208) 917-1842

Fax

(208) 549-7017

NPI assigned

Nov 16, 2012

Sex

Male

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, 2012

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Psychiatric Associates Services PLLCGroup PAC ID 7315339785, 4 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

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.

• Psychiatric Associates Services PLLC

  • Physician Assistant
  • Nampa, ID
  • NPI 1053074302
  Medicare reassignment Care Compare group Authorized official

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

{
    "created_epoch": "1353024000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1695859200000",
    "number": "1780928580",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1775 W STATE ST # 383",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837023924",
            "telephone_number": "208-912-4416",
            "fax_number": "208-549-5832"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1019 W SANETTA ST",
            "city": "NAMPA",
            "state": "ID",
            "postal_code": "836515047",
            "telephone_number": "208-917-1842",
            "fax_number": "208-549-7017"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4615 W Emerald St",
            "address_purpose": "LOCATION",
            "city": "Boise",
            "state": "ID",
            "postal_code": "837062002",
            "country_code": "US",
            "telephone_number": "208-917-1842",
            "fax_number": "208-549-7017",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1044 Northwest Blvd",
            "address_purpose": "LOCATION",
            "city": "Coeur D Alene",
            "state": "ID",
            "postal_code": "838142114",
            "country_code": "US",
            "telephone_number": "208-917-1842",
            "fax_number": "208-549-7017",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SHORT",
        "first_name": "WILLIAM",
        "middle_name": "JOSEPH",
        "credential": "PAC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-11-16",
        "last_updated": "2023-09-28",
        "certification_date": "2023-09-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "OR",
            "license": "PA160595",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "ID",
            "license": "PA1027",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Daren Shishido, D.C.
• Kelli Spessard Shoaf, LPC
• Shopko Stores Operating Co LLC
• Shopko Stores Operating Co. LLC
• Rodney R Short, DC
• Wendy M. Siegersma, M.D.
• John Sifuentes
• Maria L Sifuentes
• Signature Hospice Nampa, LLC
• Kendra Ann Siguenza

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 28, 2023; 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.