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

Individual provider Medical Physician Assistant · NPI 1164985867

Kimberly Rose Mrozek, PA-C is a Physician Assistant in Boise, Idaho. Qualified in 2019, 7 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, Kentucky and Wisconsin.

Years since qualifying
7
Licensed in
ID, KY, WI
In the registry since
2019
Specialties on file
5
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

190 E Bannock St Fl 10
Boise, ID 83712-6241
Phone: (208) 381-5500
Fax: (208) 381-2555
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 1836 South Ave, La Crosse, WI 54601-5429 — (608) 782-7300

Specialties & licences

Medical Physician Assistant (primary) Taxonomy 363AM0700X · Licence 3271156 (ID)
Medical Physician Assistant Taxonomy 363AM0700X · Licence 4845 (WI)
Physician Assistant Taxonomy 363A00000X · Licence PA2816 (KY)
Medical Physician Assistant Taxonomy 363AM0700X · Licence TC074 (KY)
Student in an Organized Health Care Education/Training Program Taxonomy 390200000X

Record details

NPI number1164985867
Entity typeIndividual (Type 1)
GenderFemale
Credentials PA-C
Sole proprietorNo
NPI enumeratedApril 9, 2019
Last updated in NPPESJuly 21, 2025
Certification dateJuly 21, 2025

Medicare enrollment

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

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2019 (7 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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