Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Emily Moore, PA-C

Individual provider Medical Physician Assistant · NPI 1891197570

Emily Moore, PA-C is a Physician Assistant in Boise, Idaho. Qualified in 2014, 12 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
12
Licensed in
ID
In the registry since
2014
What do these letters mean?
PA-C — Physician Assistant, Certified
A physician assistant who holds current national certification.

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Practice location Address checks out

701 E Parkcenter Blvd
Boise, ID 83706-6528
Phone: (208) 381-4210
Fax: (208) 381-2045
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 465 McKenna Dr, Mountain Home, ID 83647-2143 — (208) 587-9703

Specialties & licences

Medical Physician Assistant (primary) Taxonomy 363AM0700X · Licence PA-1200 (ID)

Record details

NPI number1891197570
Entity typeIndividual (Type 1)
GenderFemale
Credentials PA-C
Sole proprietorNo
NPI enumeratedSeptember 24, 2014
Last updated in NPPESOctober 10, 2024
Certification dateOctober 10, 2024
Mailing address190 E Bannock St, Boise, ID 83712-6241

Medicare enrollment

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

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2014 (12 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 locations3 on file with Medicare

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