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

Mr. Michael Robert Nieraeth, PA

Individual provider Surgical Physician Assistant · NPI 1487904280

Mr. Michael Robert Nieraeth, PA is a Physician Assistant in Boise, Idaho. Qualified in 2012, 14 years ago. Practices with The Shoulder Clinic of Idaho PLLC, a 5-clinician group, works from 2 locations and accepts Medicare assignment. Licensed in Idaho.

Years since qualifying
14
Licensed in
ID
In the registry since
2012
What do these letters mean?
PA — Physician Assistant
A licensed clinician who examines, diagnoses and treats under a physician's supervision.

See every abbreviation used in this directory →

Claim this listing Report a problem Suggest an edit

Practice location Address checks out

8854 W Emerald St Ste 102
Boise, ID 83704
Phone: (208) 323-4747
Fax: (208) 323-4848
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)

  • 320 Warner Dr, Lewiston, ID 83501-4441 — (208) 743-3523

Specialties & licences

Surgical Physician Assistant (primary) Taxonomy 363AS0400X · Licence PA-993 (ID)

Record details

NPI number1487904280
Entity typeIndividual (Type 1)
GenderMale
Credentials PA
Sole proprietorNo
NPI enumeratedSeptember 19, 2012
Last updated in NPPESMarch 25, 2019

Medicare enrollment

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

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2012 (14 years in practice)
Group practice The Shoulder Clinic Of Idaho Pllc — 5 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

Other providers in Boise