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

Phillip Imperio

Individual provider Medical Physician Assistant · NPI 1790504959

Phillip Imperio is a Physician Assistant in Boise, Idaho. Qualified in 2024, 2 years ago. Registered with an NPI since 2024.

Years since qualifying
2
In the registry since
2024

Practice location Address checks out

633 N 4th St
Boise, ID 83702-4510
Phone: (208) 342-9800
Show map & directions

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

Specialties & licences

Medical Physician Assistant (primary) Taxonomy 363AM0700X

Record details

NPI number1790504959
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorNo
NPI enumeratedOctober 5, 2024
Last updated in NPPESMay 13, 2025
Certification dateMay 13, 2025

Medicare enrollment

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

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2024 (2 years in practice)
Accepts Medicare assignment Not indicated
Practice locations2 on file with Medicare

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