Skyler S Worthington, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA-1825 Issued in ID

Practice address

156 6TH St
Potlatch, ID 83855

Phone

(208) 875-2380

Fax

(208) 875-2303

NPI assigned

Jun 20, 2011

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

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

Interoperability endpoints

• Direct secure messaging: sworthington691717@direct.ochin.org

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.

• Gritman Medical Center Inc

  • Critical Access Hospital
  • Moscow, ID
  • NPI 1619988144

  ID

  Medicare reassignment NPD
• Gritman Medical Center Inc

  • Rural Health Clinic/Center
  • Troy, ID
  • NPI 1477004828

  ID

  Medicare reassignment
• Gritman Medical Center Inc

  • Orthopaedic Surgery Physician
  • Moscow, ID
  • NPI 1811576838
  NPD
• Gritman Medical Center Inc.

  • Clinic/Center
  • Moscow, ID
  • NPI 1790182590
  NPD
• Gritman Medical Center Inc

  • Rural Health Clinic/Center
  • Potlatch, ID
  • NPI 1356438816
  NPD (past)
• Gritman Medical Center, Inc.

  • Family Medicine Physician
  • Moscow, ID
  • NPI 1538634522
  NPD (past)

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

{
    "created_epoch": "1308528000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721347200000",
    "number": "1992091722",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 8007",
            "city": "MOSCOW",
            "state": "ID",
            "postal_code": "838430507",
            "telephone_number": "208-882-4511",
            "fax_number": "208-883-6580"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "156 6TH ST",
            "city": "POTLATCH",
            "state": "ID",
            "postal_code": "83855",
            "telephone_number": "208-875-2380",
            "fax_number": "208-875-2303"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WORTHINGTON",
        "first_name": "SKYLER",
        "middle_name": "S",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-06-20",
        "last_updated": "2024-07-19",
        "certification_date": "2024-07-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "ID",
            "license": "PA-1825",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Palouse Ridge Occupational Therapy PLLC
• Suzanne Paul, M.D.
• Potlatch Family Dental, PC
• Potlatch Rural Fire Dist
• Anne M White, LICSW

• All providers in Potlatch, ID
• Physician Assistant in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 19, 2024; 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.