Austen Reis Cardoza, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

1199369 Issued in WA

Practice address

427 N 12TH St
Plummer, ID 83851

Phone

(208) 686-1931

NPI assigned

Sep 1, 2021

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, 2022

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Benewah Medical CenterGroup PAC ID 6709878622, 27 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Kootenai Health Hospital, Coeur D'Alene, ID, CCN 130049
• Benewah Community Hospital Hospital, Saint Maries, ID, CCN 131317

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Interoperability endpoints

• Direct secure messaging: acardoza812421@direct.ochin.org

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.

• Benewah Medical Center

  • Federally Qualified Health Center (FQHC)
  • Plummer, ID
  • NPI 1336135136

  ID

  Medicare reassignment Care Compare group

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Benewah Community Hospital

  • Critical Access Hospital
  • St Maries, ID
  • NPI 1548320435

  Hospital

  Care Compare affiliation
• Kootenai Health, Inc.

  • General Acute Care Hospital
  • Coeur D Alene, ID
  • NPI 1992798409

  Hospital

  Care Compare affiliation

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

{
    "created_epoch": "1630454400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1714089600000",
    "number": "1821766296",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "427 12TH STREET/ PO BOX 388",
            "city": "PLUMMER",
            "state": "ID",
            "postal_code": "83851",
            "telephone_number": "208-686-1931"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "427 N 12TH ST",
            "city": "PLUMMER",
            "state": "ID",
            "postal_code": "83851",
            "telephone_number": "208-686-1931"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARDOZA",
        "first_name": "AUSTEN",
        "middle_name": "REIS",
        "name_prefix": "Mr.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-09-01",
        "last_updated": "2024-04-26",
        "certification_date": "2021-09-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "WA",
            "license": "1199369",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Selene Bonnell-Hall
• Cathleen Constance Bourque, RDH
• John Bronsell Ryan Bronsell, PHARMD
• Meche Grace Brownlow, MAED, LPC
• Janet Butcher, RPT
• Ginger Caroline Carpenter, RN MSN
• Jason Ford Chapman, M.D.
• Rachel Chisausky, DO
• Kelli Jean Cochrane, RN
• Coeur D'Alene Tribe Physical Therapy, LLC

• All providers in Plummer, ID
• Physician Assistant in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 26, 2024; 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.