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

Kalin Danial Lister, STUDENT

Individual provider Physician Assistant · NPI 1033935093

Kalin Danial Lister, STUDENT is a Physician Assistant in Boise, Idaho. Qualified in 2024, 2 years ago. Practices with Alliance Medical Group LLC, a 130-clinician group and accepts Medicare assignment. Licensed in Idaho.

Years since qualifying
2
Licensed in
ID
In the registry since
2024

Practice location Address checks out

8971 W Overland Rd
Boise, ID 83709-1651
Phone: (208) 378-4288
Fax: (208) 378-4297
Show map & directions

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

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence 9871643 (ID)

Record details

NPI number1033935093
Entity typeIndividual (Type 1)
GenderMale
Credentials STUDENT
Sole proprietorNo
NPI enumeratedNovember 25, 2024
Last updated in NPPESMarch 5, 2025
Certification dateMarch 5, 2025

Medicare enrollment

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

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2024 (2 years in practice)
Group practice Alliance Medical Group Llc — 130 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations12 on file with Medicare

Other providers in Boise