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

Joseph E Molloy

Individual provider Physician Assistant · NPI 1194249110

Joseph E Molloy is a Physician Assistant in Fruitland, Idaho. Qualified in 2018, 8 years ago. Practices as a sole proprietor, works from 2 locations and accepts Medicare assignment. Licensed in California and Idaho.

Years since qualifying
8
Licensed in
CA, ID
In the registry since
2017
Specialties on file
2
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Practice location Address checks out

1210 NW 16th St
Fruitland, ID 83619-2202
Phone: (208) 452-8700
Fax: (208) 452-8701
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 8700 Beverly Blvd, West Hollywood, CA 90048-1804 — (310) 423-5000

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence 1671360 (ID)
Physician Assistant Taxonomy 363A00000X · Licence PA57157 (CA)

Record details

NPI number1194249110
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorYes
NPI enumeratedAugust 1, 2017
Last updated in NPPESAugust 27, 2025
Certification dateAugust 27, 2025
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 2018 (8 years in practice)
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations2 on file with Medicare

Other providers in Fruitland