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

Autumn Rose Mason, AGACNP-BC

Individual provider General Practice Registered Nurse · NPI 1386305415

Autumn Rose Mason, AGACNP-BC is a Nurse Practitioner in Boise, Idaho. Qualified in 2021, 5 years ago. Practices with St Lukes Clinic-Treasure Valley LLC, a 1,150-clinician group, works from 3 locations and accepts Medicare assignment. Licensed in Idaho.

Years since qualifying
5
Licensed in
ID
In the registry since
2021
Specialties on file
2
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Practice location Address checks out

190 E Bannock St
Boise, ID 83712-6241
Phone: (208) 381-2222
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (2)

  • 520 S Eagle Rd, Meridian, ID 83642-6351 — (208) 706-5000
  • 9850 W St Lukes Dr, Nampa, ID 83687-7912 — (208) 505-2000

Specialties & licences

Acute Care Nurse Practitioner (primary) Taxonomy 363LA2100X · Licence 71748 (ID)
General Practice Registered Nurse Taxonomy 163WG0000X · Licence 45530 (ID)

Record details

NPI number1386305415
Entity typeIndividual (Type 1)
GenderFemale
Credentials AGACNP-BC
Sole proprietorNo
NPI enumeratedDecember 30, 2021
Last updated in NPPESFebruary 22, 2022
Certification dateFebruary 22, 2022

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2021 (5 years in practice)
Group practice St Lukes Clinic-Treasure Valley Llc — 1150 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations5 on file with Medicare

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