Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Idaho Surgical Assistants PLLC

Organization Physician Assistant · NPI 1225389414

Idaho Surgical Assistants PLLC is a Physician Assistant in Boise, Idaho. Licensed in Idaho. Registered with an NPI since 2012.

Licensed in
ID
In the registry since
2012
What do these letters mean?
PLLC — Professional limited liability company
A form of business registration, not a clinical qualification.

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Practice location Address checks out

190 E Bannock St
Boise, ID 83712-6241
Phone: (208) 381-2185
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence PA-325 (ID)

Record details

NPI number1225389414
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Reanna Park — Billing Specialist · (208) 525-2090
NPI enumeratedSeptember 27, 2012
Last updated in NPPESSeptember 27, 2012
Mailing address1601 E 17th St, Idaho Falls, ID 83404-6313

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