Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of October 4, 2026.
NPIDirectory

Cody Johnson

Individual provider Physician Assistant · NPI 1184392011

Cody Johnson is a Physician Assistant in Boise, Idaho. Qualified in 2021, 5 years ago. Practices with St Lukes Clinic-Treasure Valley LLC, a 1,150-clinician group, works from 2 locations, accepts Medicare assignment and offers telehealth. 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 Fl 10
Boise, ID 83712-6241
Phone: (208) 381-5500
Show map & directions

Directions in Google Maps · Apple Maps · OpenStreetMap

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 407 S Schwartz Ave Ste 101, Farmington, NM 87401-5925 — (505) 609-6595

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence PA-2399 (ID)
Physician Assistant Taxonomy 363A00000X

Record details

NPI number1184392011
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorNo
NPI enumeratedSeptember 3, 2021
Last updated in NPPESNovember 30, 2022
Certification dateNovember 30, 2022

Medicare enrollment

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

Medicare specialtyPHYSICIAN ASSISTANT
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
TelehealthOffers telehealth services
Practice locations4 on file with Medicare

Medicare patients and services, 2024

From the CMS Medicare Physician & Other Practitioners file for calendar year 2024. It counts Original Medicare patients only, so a practice that mostly sees Medicare Advantage or privately insured patients looks smaller here than it is.

Medicare patients31
Services billed 153 a service is one billed item, such as a visit, a test or a procedure
Average patient age73

Dollar amounts are not shown. What Medicare pays a practice is gross billings, before staff, premises and tax and including the cost of any drugs it administers, so it is not what a clinician earns.

Payments from drug and device companies, 2025

Drug and device makers are required by federal law (the Physician Payments Sunshine Act) to report what they pay or give to clinicians, and CMS publishes the reports as Open Payments. This is the 2025 program year. A report is a record of a payment, not an allegation of anything, and many are small items such as meals. Only general payments are listed here; research payments and ownership or investment interests are reported separately by CMS and are not shown.

Food and Beverage $15 1 payment · a meal or drink at a meeting or visit, not a fee

Each amount is the sum of what companies reported for that kind of payment in 2025, rounded to the dollar. Not all of it is income to the clinician: a meal is not a fee, a charitable contribution goes to a charity, and a royalty or an acquisition payment is not a salary.

Check a report, or dispute one, at the source in CMS’s own tool, Open Payments. Corrections go through CMS’s dispute process. This site removes a home address on request and asks for no proof, because that is privacy; it will not remove an accurate payment report on request, because that is a statutory public disclosure.

Practises at

Facilities the CMS Facility Affiliation file lists for this clinician. Those with a page here are linked.

Colleagues at St Lukes Clinic-Treasure Valley LLC

Clinicians the CMS Doctors & Clinicians file lists under the same group practice. CMS counts 1150 clinicians in the practice; 12 are shown here.

Other providers in Boise