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

Lee S Gardner, PA-C

Individual provider Medical Physician Assistant · NPI 1063589612

Lee S Gardner, PA-C is a Physician Assistant in Idaho Falls, Idaho. Qualified in 1998, 28 years ago. Practices with Dallco Orthopaedics and Sports Medicine, a 2-clinician group and accepts Medicare assignment. Licensed in Idaho.

Years since qualifying
28
Licensed in
ID
In the registry since
2006
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

2725 Channing Way
Idaho Falls, ID 83404-7510
Phone: (208) 525-8448
Fax: (208) 525-8118
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Medical Physician Assistant (primary) Taxonomy 363AM0700X · Licence PA-359 (ID)

Record details

NPI number1063589612
Entity typeIndividual (Type 1)
GenderMale
Credentials PA-C
Sole proprietorNo
NPI enumeratedNovember 29, 2006
Last updated in NPPESDecember 7, 2009

Medicare enrollment

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

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 1998 (28 years in practice)
Group practice Dallco Orthopaedics And Sports Medicine — 2 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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