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

Mr. Robert William Porter, PA-C

Individual provider Physician Assistant · NPI 1861565988

Mr. Robert William Porter, PA-C is a Physician Assistant in Boise, Idaho. Qualified in 2001, 25 years ago. Practices with St Lukes Clinic-Treasure Valley LLC, a 1,150-clinician group and accepts Medicare assignment. Licensed in Arizona and Idaho.

Years since qualifying
25
Licensed in
AZ, ID
In the registry since
2006
Specialties on file
3
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

190 E Bannock St
Boise, ID 83712-6241
Phone: (480) 688-6930
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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 PA-1287 (ID)
Physician Assistant Taxonomy 363A00000X · Licence 2551 (AZ)
Physician Assistant Taxonomy 363A00000X · Licence 1287 (ID)

Record details

NPI number1861565988
Entity typeIndividual (Type 1)
GenderMale
Credentials PA-C
Sole proprietorNo
NPI enumeratedNovember 16, 2006
Last updated in NPPESApril 12, 2023
Certification dateApril 12, 2023

Medicare enrollment

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

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2001 (25 years in practice)
Group practice St Lukes Clinic-Treasure Valley Llc — 1150 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations3 on file with Medicare

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