Individual provider Active NPI

Alan Adams, PA-C

  • Physician Assistant
  • Idaho Falls, ID
National Provider Identifier
1891188348
Registry record updated Nov 3, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA-1232 Issued in ID
Practice address
3820 Crestwood LN
Idaho Falls, ID 83404-4979
Phone
(208) 552-7700
NPI assigned
Mar 9, 2015
Last updated
Nov 3, 2020By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 3, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA-1232 ID Primary

Addresses

Primary practice location

3820 Crestwood LN
Idaho Falls, ID 83404-4979

Mailing address

3820 Crestwood LN
Idaho Falls, ID 83404-4979
Phone (208) 552-7700

Other practice location 1

2088 E 25th St
Idaho Falls, ID 83404-6490
Phone (208) 528-7655

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
I20150825005722 ID Practitioner - Physician Assistant 1759609878 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Family First Medical Center PLLCGroup PAC ID 1052480076, 18 clinicians

Practice addresses (Care Compare)

3820 Crestwood LN
Idaho Falls, ID 83404-4979
Phone 2085527700837

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PA-1232IDMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Community Council of Idaho, Inc. Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: alan.adams@ffmcif.eclinicaldirectplus.com

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 3

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": "1425859200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1604361600000",
    "number": "1891188348",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3820 CRESTWOOD LN",
            "city": "IDAHO FALLS",
            "state": "ID",
            "postal_code": "834044979",
            "telephone_number": "208-552-7700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3820 CRESTWOOD LN",
            "city": "IDAHO FALLS",
            "state": "ID",
            "postal_code": "834044979",
            "telephone_number": "208-552-7700"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2088 E 25th St",
            "address_purpose": "LOCATION",
            "city": "Idaho Falls",
            "state": "ID",
            "postal_code": "834046490",
            "country_code": "US",
            "telephone_number": "208-528-7655",
            "fax_number": "208-524-9390",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ADAMS",
        "first_name": "ALAN",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-03-09",
        "last_updated": "2020-11-03",
        "certification_date": "2020-11-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "ID",
            "license": "PA-1232",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Idaho Falls, ID

Sources for this page

Verify at the official NPI Registry.