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

Mariah Emily McReynolds

Individual provider Physician Assistant · NPI 1528570991

Mariah Emily McReynolds is a Physician Assistant in Boise, Idaho. Qualified in 2017, 9 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 California and Idaho.

Years since qualifying
9
Licensed in
CA, ID
In the registry since
2017
Specialties on file
2
Claim this listing Report a problem Suggest an edit

Practice location Address checks out

190 E Bannock St
Boise, ID 83712-6241
Phone: (208) 381-5015
Show map & directions

Directions in Google Maps · Apple Maps · OpenStreetMap

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 27300 Iris Ave, Moreno Valley, CA 92555-4802 — (951) 243-0811

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence PA-2511 (ID)
Physician Assistant Taxonomy 363A00000X · Licence PA55182 (CA)

Record details

NPI number1528570991
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorNo
NPI enumeratedOctober 25, 2017
Last updated in NPPESOctober 5, 2023
Certification dateOctober 5, 2023

Medicare enrollment

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

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2017 (9 years in practice)
Group practice St Lukes Clinic-Treasure Valley Llc — 1150 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations5 on file with Medicare

Other providers in Boise