Phillip Imperio

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

Practice address

633 N 4TH St
Boise, ID 83702-4510

Phone

(208) 342-9800

NPI assigned

Oct 5, 2024

Last updated

May 13, 2025By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

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

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

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.

• Pain Center Inc

  • Pain Clinic/Center
  • Boise, ID
  • NPI 1740582303
  Medicare reassignment

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

{
    "created_epoch": "1728086400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1747094400000",
    "number": "1790504959",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "633 N 4TH ST",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837024510"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "633 N 4TH ST",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837024510",
            "telephone_number": "208-342-9800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "IMPERIO",
        "first_name": "PHILLIP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-10-05",
        "last_updated": "2025-05-13",
        "certification_date": "2025-05-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Rachel Illias, PHARMD
• Illumination Women's Health PLLC
• Christina Imgrund, M.A., BCBA
• Margaret Imlay, BCBA
• Impact Counseling and Treatment Services, LLC
• Impilocare LLC
• In His Image PT, LLC
• Nancy Sadako Inaba, O.T.R.
• Incline Mental Health PLLC
• Include Autism, Inc.

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 13, 2025; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.