Andrea Krogh, PA-C
Individual provider Active NPI Medical Physician Assistant · Cottonwood, ID
NPI 1922018027 · NPPES record last updated Aug 6, 2021
Key facts
- NPI
- 1922018027
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Medical Physician Assistant 363AM0700X
- License
- PA327 (ID)
- Practice address
- 701 Lewiston Street
Cottonwood, ID 83522-0565 - Phone
- (208) 962-3267
- Fax
- (208) 962-2313
- NPI assigned
- Aug 9, 2006
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 9
Hospital & facility affiliations 17
Medicare Care Compare profile
- Specialty
- Physician Assistant
- Education
- Other, 2000
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- St Marys Hospital Inc
Practice addresses (Care Compare)
501 Oak St
Nezperce, ID 83543-5064
Phone (208) 937-2496
701 Lewiston St
Cottonwood, ID 83522-9750
Phone (208) 962-3251
Hospital & facility affiliations
- Syringa General Hospital Hospice
- St Mary'S Hospital
- St Joseph Regional Medical Center
- Clearwater Valley Hospital & Clinics
- Syringa General Hospital
- Gritman Medical Center
Merit-based Incentive Payment System (MIPS)
- Final score
- 86.65 of 100
- Quality
- 89.26
- Promoting interoperability
- 69.9
- Improvement activities
- 40
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (2 enrollments) in ID, TX
- 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 |
|---|---|---|---|---|
| I20110901000593 | ID | Practitioner - Physician Assistant | 5799955605 | Reassigns benefits to 3 organizations |
| I20120105000305 | TX | Practitioner - Physician Assistant | 5799955605 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PA327 | ID | MD | Medical Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Clearwater Valley Hospital & Clinics Inc. | Physician Assistant | Current |
Accepting new patients |
| St. Mary'S Hospital Inc | Current |
Accepting new patients | |
| St. Mary'S Hospital Inc | Current |
Accepting new patients | |
| St. Mary'S Hospital Inc | Current | Accepting new patients | |
| Clearwater Valley Hospital & Clinics Inc. | Current |
Accepting new patients | |
| St. Mary'S Hospital Inc | Past | Accepting new patients |
Locations
2003 Kootenai Health Way
Coeur D Alene, ID 83814
Phone (208) 625-5085
701 Lewiston St
Cottonwood, ID 83522
Phone (208) 962-3251
501 Oak St
Nezperce, ID 83543
Phone (208) 937-2496
301 Cedar St
Orofino, ID 83544
Phone (208) 476-4555
Interoperability endpoints
- andreakrogh@smhcvhc.medalliesdirect.net
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | PA327 | ID | |
| Medical Physician Assistant | 363AM0700X | PA327 | ID | Yes |
Addresses
Primary practice location
701 Lewiston Street
Cottonwood, ID 83522-0565
Mailing address
2003 Kootenai Health Way
Coeur D Alene, ID 83814-6051
Phone (208) 962-3251
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1922018027 | Other | ID | BLUE CROSS OF IDAHO |
| 1922018027 | Medicaid | ID | |
| 8B529 | Other | ID | BCBS |
| 1922018027 | Other | ID | REGENCE BLUE SHIELD OF IDAHO |
| 805010100 | Medicaid | ID |
Other providers in Cottonwood, ID
- Ronald Lee Jeanblanc II
- Tema Lynn Jessup
- Andrew F Jones
- Justin Leroy Jones
- Rebecca S Kirk-Ewing
- Jacey Jo Mae Langston
- Kevin Lienesch
- Leann Maria Lightfield
- Todd K. McAllister
- Taresa Lynn Michna
All providers in Cottonwood, 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 Aug 6, 2021. 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.