Individual provider Active NPI

Victoria S Rogers, PA-C

  • Physician Assistant
  • Ontario, OR
National Provider Identifier
1922106194
Registry record updated Jul 14, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA-401 Issued in ID
Practice address
351 SW 9TH St
Ontario, OR 97914-2639
Phone
(541) 881-7373
Fax
(541) 881-7186
NPI assigned
Sep 20, 2006
Last updated
Jul 14, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 14, 2022

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-401 ID Primary

Addresses

Primary practice location

351 SW 9TH St
Ontario, OR 97914-2639

Mailing address

215 E Hawaii Ave
Nampa, ID 83686-6011
Phone (208) 463-3000

Other practice location 1

500 W Fort St
# 111
Boise, ID 83702
Phone (208) 422-1325

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
I20110623000697 ID Practitioner - Physician Assistant 8527106475 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
87.3 of 100Reported as group
Quality
81.29
Promoting interoperability
100
Improvement activities
40
Cost
76.37

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
St Lukes Clinic-Treasure Valley LLC CurrentSince May 1, 2012 Accepting new patients
The Neighborhood Clinic, LLC PastSince Sep 1, 2015 Accepting new patients
Edward H Newcombe PastSince Oct 1, 1997 Accepting new patients
Darrell a. Kammer, a Professional Association PastSince Feb 4, 2003 Accepting new patients
Idaho Emergency Physicians, P.a. PastSince Dec 1, 2011 Accepting new patients

Locations

1520 W State St
Ste 100
Boise, ID 83702
Phone (208) 947-7700

610 W Hays St
Boise, ID 83702
Phone (208) 345-3530

520 S Eagle Rd
Ste 2116
Meridian, ID 83642
Phone (208) 884-2999

215 E Hawaii Ave
Nampa, ID 83686
Phone (208) 463-3234

351 SW 9th St
Ontario, OR 97914
Phone (541) 881-7000

Organizations & group practices 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1158710400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1657756800000",
    "number": "1922106194",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "215 E HAWAII AVE",
            "city": "NAMPA",
            "state": "ID",
            "postal_code": "836866011",
            "telephone_number": "208-463-3000",
            "fax_number": "208-463-3044"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "351 SW 9TH ST",
            "city": "ONTARIO",
            "state": "OR",
            "postal_code": "979142639",
            "telephone_number": "541-881-7373",
            "fax_number": "541-881-7186"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "500 W Fort St",
            "address_2": "# 111",
            "address_purpose": "LOCATION",
            "city": "Boise",
            "state": "ID",
            "postal_code": "83702",
            "country_code": "US",
            "telephone_number": "208-422-1325",
            "fax_number": "208-422-1319",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ROGERS",
        "first_name": "VICTORIA",
        "middle_name": "S",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-20",
        "last_updated": "2022-07-14",
        "certification_date": "2022-07-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "ID",
            "license": "PA-401",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ontario, OR

Sources for this page

Verify at the official NPI Registry.