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

Kacey Blea

Individual provider Student in an Organized Health Care Education/Training Program · NPI 1205561727

Kacey Blea is a Physician Assistant in Boise, Idaho. Qualified in 2023, 3 years ago. Practices with St Lukes Clinic-Treasure Valley LLC, a 1,150-clinician group, works from 2 locations and accepts Medicare assignment. Licensed in Idaho.

Years since qualifying
3
Licensed in
ID
In the registry since
2022
Specialties on file
3
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Practice location Address checks out

100 E Idaho St
Boise, ID 83712-6267
Phone: (208) 381-4171
Fax: (208) 381-4172
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 921 S 8th Ave Stop 8253, Pocatello, ID 83209-0002 — (208) 282-4726

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence PA-2652 (ID)
Student in an Organized Health Care Education/Training Program Taxonomy 390200000X
Physician Assistant Taxonomy 363A00000X · Licence 1214536 (ID)

Record details

NPI number1205561727
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorNo
NPI enumeratedJuly 19, 2022
Last updated in NPPESJanuary 17, 2024
Certification dateJanuary 17, 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 2023 (3 years in practice)
Group practice St Lukes Clinic-Treasure Valley Llc — 1150 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations6 on file with Medicare

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