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

Mitchell Eric Blume, PA-C, RD, CDE

Individual provider Surgical Physician Assistant · NPI 1710334248

Mitchell Eric Blume, PA-C, RD, CDE 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 Idaho and Washington.

Years since qualifying
9
Licensed in
ID, WA
In the registry since
2016
Specialties on file
3
What do these letters mean?
PA-C — Physician Assistant, Certified
A physician assistant who holds current national certification.
RD — Registered Dietitian
A credentialed nutrition professional.
CDE — Certified Diabetes Educator
Teaches people to manage diabetes day to day.

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Practice location Address checks out

190 E Bannock St
Boise, ID 83712-6241
Phone: (208) 381-5015
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 750 N Syringa St Ste 205, Post Falls, ID 83854-5275 — (208) 262-0945

Specialties & licences

Surgical Physician Assistant (primary) Taxonomy 363AS0400X · Licence PA-2266 (ID)
Surgical Physician Assistant Taxonomy 363AS0400X · Licence PA-1517 (ID)
Surgical Physician Assistant Taxonomy 363AS0400X · Licence PA60794259 (WA)

Record details

NPI number1710334248
Entity typeIndividual (Type 1)
GenderMale
Credentials PA-C , RD , CDE
Sole proprietorNo
NPI enumeratedMay 13, 2016
Last updated in NPPESJune 30, 2022
Certification dateJune 30, 2022
Mailing address190 E Bannock St, Boise, ID 83712-6241

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 locations8 on file with Medicare

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