Ramon Addison Relyea, PA-C

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

PA-1084 Issued in ID

Practice address

3224 N Maple Grove Rd
Boise, ID 83704-4214

Phone

(208) 888-3358

NPI assigned

Nov 24, 2010

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

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

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

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.

• Alliance Medical Group, LLC

  • Family Medicine Physician
  • Garden City, ID
  • NPI 1568413920
  NPD

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

{
    "created_epoch": "1290556800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1687478400000",
    "number": "1972805943",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2301 E SADIE DR",
            "city": "EAGLE",
            "state": "ID",
            "postal_code": "836165409",
            "telephone_number": "530-520-7796"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3224 N MAPLE GROVE RD",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837044214",
            "telephone_number": "208-888-3358"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RELYEA",
        "first_name": "RAMON",
        "middle_name": "ADDISON",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-11-24",
        "last_updated": "2023-06-23",
        "certification_date": "2023-06-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "WA",
            "license": "PA60193367",
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "UT",
            "license": "10927277-1206",
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "ID",
            "license": "PA-1084",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Adrienne Demi Reiswig, AUD
• Joseph J Reitan, DPT
• Katheryn Rekow, LMT
• Relax a Back Bodyworks LLC
• Reliant Senior Living LLC
• Rem Idaho, LLC
• Michaela Remley, RN, BSN
• James Bucknall Remmel Jr., M.D.
• Erin M Renak, PA-C, MPAP
• James Arthur Reneau

• Medical Physician Assistant in Boise, ID
• Providers in Boise, ID by specialty
• Medical Physician Assistant in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 23, 2023; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.