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

Katelyn Cramer Wade, PA, RD

Individual provider Registered Dietitian · NPI 1780178814

Katelyn Cramer Wade, PA, RD is a Physician Assistant in Boise, Idaho. Qualified in 2021, 5 years ago. Practices with Idaho Skin Surgery Center PC, a 4-clinician group and accepts Medicare assignment. Licensed in Idaho.

Years since qualifying
5
Licensed in
ID
In the registry since
2018
Specialties on file
2
What do these letters mean?
PA — Physician Assistant
A licensed clinician who examines, diagnoses and treats under a physician's supervision.
RD — Registered Dietitian
A credentialed nutrition professional.

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Practice location Address checks out

1906 S Vista Ave
Boise, ID 83705-3453
Phone: (208) 433-1114
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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-2113 (ID)
Registered Dietitian Taxonomy 133V00000X · Licence D-935 (ID)

Record details

NPI number1780178814
Entity typeIndividual (Type 1)
GenderFemale
Credentials PA , RD
Sole proprietorNo
NPI enumeratedJune 21, 2018
Last updated in NPPESMarch 7, 2022
Certification dateMarch 7, 2022
Mailing address1906 S Vista Ave, Boise, ID 83705-3453

Medicare enrollment

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

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2021 (5 years in practice)
Group practice Idaho Skin Surgery Center Pc — 4 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations2 on file with Medicare

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