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

Cody Mattingly

Individual provider Medical Physician Assistant · NPI 1952889685

Cody Mattingly is a Physician Assistant in Boise, Idaho. Qualified in 2018, 8 years ago. Practices with Alliance Medical Group LLC, a 130-clinician group, accepts Medicare assignment and offers telehealth. Licensed in Idaho.

Years since qualifying
8
Licensed in
ID
In the registry since
2018
Specialties on file
2
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Practice location Address checks out

1475 N Cole Rd
Boise, ID 83704-8537
Phone: (208) 809-2880
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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-1677 (ID)
Medical Physician Assistant Taxonomy 363AM0700X

Record details

NPI number1952889685
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorNo
NPI enumeratedAugust 3, 2018
Last updated in NPPESFebruary 25, 2021
Certification dateFebruary 25, 2021

Medicare enrollment

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

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2018 (8 years in practice)
Group practice Alliance Medical Group Llc — 130 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
TelehealthOffers telehealth services
Practice locations5 on file with Medicare

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