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

Cody Elijah Wissenbach, PA

Individual provider Physician Assistant · NPI 1841468410

Cody Elijah Wissenbach, PA is a Physician Assistant in Boise, Idaho. Qualified in 2007, 19 years ago. Practices with Saint Alphonsus Regional Medical Center Inc, a 673-clinician group, works from 4 locations and accepts Medicare assignment. Licensed in Idaho, Nevada and Washington.

Years since qualifying
19
Licensed in
ID, NV, WA
In the registry since
2008
Specialties on file
3
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

999 N Curtis Rd Ste 415
Boise, ID 83706-1334
Phone: (208) 302-2600
Fax: (208) 302-2625
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (3)

  • 3841 W Charleston Blvd Ste 203, Las Vegas, NV 89102-1858 — (702) 848-4443
  • 6770 S McCarran Blvd, Reno, NV 89509-6103 — (775) 770-3254
  • 1411 4th Ave, Seattle, WA 98101-2249 — (253) 271-9720

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence PA-2289 (ID)
Physician Assistant Taxonomy 363A00000X · Licence PA1091 (NV)
Physician Assistant Taxonomy 363A00000X · Licence PA60720417 (WA)

Record details

NPI number1841468410
Entity typeIndividual (Type 1)
GenderMale
Credentials PA
Sole proprietorNo
NPI enumeratedFebruary 15, 2008
Last updated in NPPESNovember 14, 2023
Certification dateNovember 14, 2023

Medicare enrollment

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

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2007 (19 years in practice)
Group practice Saint Alphonsus Regional Medical Center Inc — 673 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations2 on file with Medicare

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