Individual provider Active NPI

Thea Heaton, PA-C

  • Physician Assistant
  • Nampa, ID
National Provider Identifier
1811998628
Registry record updated Feb 9, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA474 Issued in ID
Practice address
318 2ND St S
Nampa, ID 83651-3765
Phone
(208) 467-3006
Fax
(208) 467-1155
NPI assigned
Aug 2, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 9, 2016

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA00597 OR
Physician Assistant 363A00000X PA474 ID Primary

Addresses

Primary practice location

318 2ND St S
Nampa, ID 83651-3765

Mailing address

318 2ND St S
Nampa, ID 83651-3765
Phone (208) 467-3006

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
I20040205000920 ID Practitioner - Physician Assistant 9931092608 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Dermatology Center of Canyon CountyGroup PAC ID 3072589209, 6 clinicians

Practice addresses (Care Compare)

318 2ND St S
Nampa, ID 83651-3765
Phone (208) 463-3006

Hospital & facility affiliations

  • St Luke'S Nampa Medical Center Hospital, Nampa, ID, CCN 130071

Merit-based Incentive Payment System (MIPS)

Final score
97.12 of 100Reported as group
Quality
94.24
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PA474IDMDPhysician Assistant
PA00597ORMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Stephen William Doggett, M.D. PA Past Accepting new patients

Organizations & group practices 2

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.

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": "1122940800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1454976000000",
    "number": "1811998628",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "318 2ND ST S",
            "city": "NAMPA",
            "state": "ID",
            "postal_code": "836513765",
            "telephone_number": "208-467-3006",
            "fax_number": "208-467-1155"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "318 2ND ST S",
            "city": "NAMPA",
            "state": "ID",
            "postal_code": "836513765",
            "telephone_number": "208-467-3006",
            "fax_number": "208-467-1155"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HEATON",
        "first_name": "THEA",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-08-02",
        "last_updated": "2016-02-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "OR",
            "license": "PA00597",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "ID",
            "license": "PA474",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Nampa, ID

Sources for this page

Verify at the official NPI Registry.