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

Individual provider Physician Assistant · NPI 1083837942

Kathleen Anneke, PA-C is a Physician Assistant in Boise, Idaho. Qualified in 2001, 25 years ago. Practices with Saint Alphonsus Regional Medical Center Inc, a 673-clinician group, works from 3 locations and accepts Medicare assignment. Licensed in Idaho.

Years since qualifying
25
Licensed in
ID
In the registry since
2007
Specialties on file
3
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

1072 N Liberty St Ste 100
Boise, ID 83704-8708
Phone: (208) 302-1200
Fax: (208) 302-1255
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (2)

  • 165 Maa St, Kahului, HI 96732-3603 — (808) 446-7120
  • 875 S Vanguard Way Ste 200, Meridian, ID 83642-8542 — (208) 463-3000

Specialties & licences

Surgical Physician Assistant (primary) Taxonomy 363AS0400X · Licence PA-378 (ID)
Physician Assistant Taxonomy 363A00000X
Physician Assistant Taxonomy 363A00000X · Licence PA-378 (ID)

Record details

NPI number1083837942
Entity typeIndividual (Type 1)
GenderFemale
Credentials PA-C
Sole proprietorNo
NPI enumeratedApril 10, 2007
Last updated in NPPESFebruary 27, 2024
Certification dateFebruary 27, 2024

Medicare enrollment

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

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2001 (25 years in practice)
Group practice Saint Alphonsus Regional Medical Center Inc — 673 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations2 on file with Medicare

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