Dirk Kenneth Baskett, PA-C
Individual provider Active NPI Medical Physician Assistant · Mountain Home, ID
NPI 1841920220 · NPPES record last updated Dec 23, 2022
Key facts
- NPI
- 1841920220
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Medical Physician Assistant 363AM0700X
- License
- PA-2374 (ID)
- Practice address
- 840 N 4TH E
Mountain Home, ID 83647-2166 - Phone
- (208) 587-1850
- NPI assigned
- Jun 16, 2022
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 4
Hospital & facility affiliations 4
Medicare Care Compare profile
- Specialty
- Physician Assistant
- Education
- Other, 2022
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- St Lukes Clinic-Treasure Valley LLC
Practice addresses (Care Compare)
608 W Hays St
Boise, ID 83702-5511
Phone (208) 381-5970
610 W Hays St
Boise, ID 83702-5511
Phone (208) 381-5970
Hospital & facility affiliations
- St Luke'S Elmore Medical Center
- St Luke'S Regional Medical Center
Merit-based Incentive Payment System (MIPS)
- Final score
- 87.3 of 100
- Quality
- 81.29
- Promoting interoperability
- 100
- Improvement activities
- 40
- Cost
- 76.37
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in ID
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20221117002808 | ID | Practitioner - Physician Assistant | 4385012624 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PA-2374 | ID | MD | Medical Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| St Lukes Clinic-Treasure Valley LLC | Current |
Accepting new patients | |
| St Lukes Regional Medical Center | Past | Accepting new patients |
Locations
190 E Bannock St
Boise, ID 83712
Phone (208) 381-2378
610 W Hays St
Boise, ID 83702
Phone (208) 345-3530
840 N 4th E
Mountain Home, ID 83647
Phone (208) 587-1850
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Medical Physician Assistant | 363AM0700X | PA-2374 | ID | Yes |
Addresses
Primary practice location
840 N 4TH E
Mountain Home, ID 83647-2166
Mailing address
840 N 4TH E
Mountain Home, ID 83647-2166
Phone (208) 587-1850
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 500812528 | Medicaid | OR |
Other providers in Mountain Home, ID
- Paul Giovanni Ayala Ramos
- Amy S Baker
- Scott Alan Baldridge
- Veronica Ballek
- Lester Barroso
- Dawn D Best
- Brion Prince Bethel Sr.
- Tracy Lynn Bideganeta
- Boise Vamc
- Shelby Bonello
All providers in Mountain Home, ID · Medical Physician Assistant in Idaho
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 23, 2022. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.