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

Misty Neisen

Individual provider Physician Assistant · NPI 1023409265

Misty Neisen is a Physician Assistant in Boise, Idaho. Qualified in 2014, 12 years ago. Practices with St Lukes Clinic-Treasure Valley LLC, a 1,150-clinician group and accepts Medicare assignment. Licensed in Idaho.

Years since qualifying
12
Licensed in
ID
In the registry since
2015
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Practice location Address checks out

100 E Idaho St
Boise, ID 83712-6267
Phone: (208) 381-2711
Fax: (208) 381-4025
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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 PA1189 (ID)

Record details

NPI number1023409265
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorNo
NPI enumeratedFebruary 10, 2015
Last updated in NPPESMarch 28, 2022
Certification dateMarch 28, 2022

Medicare enrollment

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

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2014 (12 years in practice)
Group practice St Lukes Clinic-Treasure Valley Llc — 1150 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations7 on file with Medicare

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