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

Carly Sienna Wilson, PA

Individual provider Medical Physician Assistant · NPI 1316677636

Carly Sienna Wilson, PA is a Physician Assistant in Boise, Idaho. Qualified in 2022, 4 years ago. Practices with Community Health Clinics Inc, a 74-clinician group, works from 3 locations and accepts Medicare assignment. Licensed in Idaho.

Years since qualifying
4
Licensed in
ID
In the registry since
2022
Specialties on file
2
What do these letters mean?
PA — Physician Assistant
A licensed clinician who examines, diagnoses and treats under a physician's supervision.

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Practice location Address checks out

100 E Idaho St Ste 302
Boise, ID 83712-6269
Phone: (208) 343-7501
Fax: (208) 336-8248
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (2)

  • 300 S 23rd St, Boise, ID 83702-9100 — (208) 344-3512
  • 921 S 8th Ave Stop 8253, Pocatello, ID 83209-2205 — (208) 282-4726

Specialties & licences

Medical Physician Assistant (primary) Taxonomy 363AM0700X · Licence PA-2349 (ID)
Physician Assistant Taxonomy 363A00000X

Record details

NPI number1316677636
Entity typeIndividual (Type 1)
GenderFemale
Credentials PA
Sole proprietorNo
NPI enumeratedJune 10, 2022
Last updated in NPPESMarch 2, 2026
Certification dateMarch 2, 2026

Medicare enrollment

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

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2022 (4 years in practice)
Group practice Community Health Clinics Inc — 74 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations3 on file with Medicare

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