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

Kenneth Justin Grover, PA

Individual provider Physician Assistant · NPI 1689393654

Kenneth Justin Grover, PA is a Physician Assistant in Boise, Idaho. Graduated from University of Washington School of Medicine in 2023, 3 years ago. Practices with Boise Radiology Group PLLC, a 63-clinician group and accepts Medicare assignment.

Years since qualifying
3
Trained at
University of Washington School of Medicine
In the registry since
2022
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.

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Practice location Address checks out

620 W Hays St
Boise, ID 83702-5511
Phone: (208) 381-2094
Fax: (208) 381-1791
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X
Student in an Organized Health Care Education/Training Program Taxonomy 390200000X

Record details

NPI number1689393654
Entity typeIndividual (Type 1)
GenderMale
Credentials PA
Sole proprietorNo
NPI enumeratedAugust 24, 2022
Last updated in NPPESSeptember 7, 2023
Certification dateSeptember 7, 2023

Medicare enrollment

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

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolUNIVERSITY OF WASHINGTON SCHOOL OF MEDICINE
Graduated 2023 (3 years in practice)
Group practice Boise Radiology Group Pllc — 63 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations7 on file with Medicare

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