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

Lauren Moak

Individual provider Physician Assistant · NPI 1417630559

Lauren Moak is a Physician Assistant in Meridian, Idaho. Qualified in 2025, 1 year ago. Practices with St Lukes Clinic-Treasure Valley LLC, a 1,150-clinician group and accepts Medicare assignment. Licensed in Idaho.

Years since qualifying
1
Licensed in
ID
In the registry since
2023
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Practice location Address checks out

520 S Eagle Rd
Meridian, ID 83642-6351
Phone: (208) 706-5651
Fax: (208) 706-5344
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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 1271985 (ID)

Record details

NPI number1417630559
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorNo
NPI enumeratedAugust 7, 2023
Last updated in NPPESNovember 11, 2025
Certification dateNovember 11, 2025

Medicare enrollment

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

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2025 (1 years in practice)
Group practice St Lukes Clinic-Treasure Valley Llc — 1150 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations3 on file with Medicare

Other providers in Meridian