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

Mr. Ronnie Bryon Isaacson, PHYSICIANASSISTANT

Individual provider Physician Assistant · NPI 1275007965

Mr. Ronnie Bryon Isaacson, PHYSICIANASSISTANT is a Physician Assistant in Boise, Idaho. Qualified in 2017, 9 years ago. Practices with Numinus Wellness UT Inc, a 51-clinician group, works from 7 locations, accepts Medicare assignment and offers telehealth. Licensed in Idaho and Oregon.

Years since qualifying
9
Licensed in
ID, OR
In the registry since
2019
Specialties on file
2
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Practice location Address checks out

4615 W Emerald St
Boise, ID 83706-2002
Phone: (208) 917-1842
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (6)

  • 2609 S 10th Ave, Caldwell, ID 83605-6816 — (208) 841-3020
  • 1044 Northwest Blvd Ste C, Coeur D Alene, ID 83814-2114 — (208) 917-1842
  • 1019 W Sanetta St, Nampa, ID 83651-5047 — (208) 917-1842
  • 595 Nw 11th St, Hermiston, OR 97838-6600 — (541) 567-2536
  • 702 Sunset Dr, Ontario, OR 97914-3121 — (541) 889-9167
  • 331 Se 2nd St, Pendleton, OR 97801-2224 — (541) 276-6207

Specialties & licences

Medical Physician Assistant (primary) Taxonomy 363AM0700X · Licence PA-1707 (ID)
Physician Assistant Taxonomy 363A00000X · Licence PA191453 (OR)

Record details

NPI number1275007965
Entity typeIndividual (Type 1)
GenderMale
Credentials PHYSICIANASSISTANT
Sole proprietorYes
NPI enumeratedJanuary 15, 2019
Last updated in NPPESMarch 31, 2022
Certification dateMarch 31, 2022

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 Numinus Wellness Ut Inc — 51 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
TelehealthOffers telehealth services

Other providers in Boise