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

MS. Krysta Nicole Carlson, PA-C

Individual provider Physician Assistant · NPI 1740698356

MS. Krysta Nicole Carlson, PA-C is a Physician Assistant in Homedale, Idaho. Qualified in 2014, 12 years ago. Practices with Clinicas Del Camino Real Inc, a 99-clinician group, works from 2 locations and accepts Medicare assignment. Licensed in California and Idaho.

Years since qualifying
12
Licensed in
CA, ID
In the registry since
2014
Specialties on file
2
What do these letters mean?
PA-C — Physician Assistant, Certified
A physician assistant who holds current national certification.

See every abbreviation used in this directory →

Practice location Address checks out

108 E Idaho Ave
Homedale, ID 83628-5003
Phone: (208) 337-3189
Fax: (208) 466-5359
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 1000 Newbury Rd, Newbury Park, CA 91320-6435 — (805) 498-3640

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence 5081403 (ID)
Physician Assistant Taxonomy 363A00000X · Licence PA51782 (CA)

Record details

NPI number1740698356
Entity typeIndividual (Type 1)
GenderFemale
Credentials PA-C
Sole proprietorNo
NPI enumeratedJuly 27, 2014
Last updated in NPPESJune 5, 2026
Certification dateJune 5, 2026

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 Clinicas Del Camino Real Inc — 99 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations2 on file with Medicare