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

Rilee Wong Mickelsen, PA-C

Individual provider Medical Physician Assistant · NPI 1770346835

Rilee Wong Mickelsen, PA-C is a Physician Assistant in Boise, Idaho. Qualified in 2023, 3 years ago. Practices with Saint Alphonsus Regional Medical Center Inc, a 673-clinician group, works from 2 locations and accepts Medicare assignment. Licensed in Idaho and Pennsylvania.

Years since qualifying
3
Licensed in
ID, PA
In the registry since
2024
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

1072 N Liberty St Ste 201
Boise, ID 83704-8708
Phone: (208) 302-2400
Fax: (208) 302-2455
Show map & directions

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

Additional practice locations (1)

  • 111 S 11th St Ste 8290, Philadelphia, PA 19107-4824 — (215) 955-6161

Specialties & licences

Surgical Physician Assistant (primary) Taxonomy 363AS0400X · Licence 8061671 (ID)
Medical Physician Assistant Taxonomy 363AM0700X · Licence MA065365 (PA)
Surgical Physician Assistant Taxonomy 363AS0400X · Licence MA065365 (PA)

Record details

NPI number1770346835
Entity typeIndividual (Type 1)
GenderFemale
Credentials PA-C
Sole proprietorNo
NPI enumeratedFebruary 1, 2024
Last updated in NPPESSeptember 3, 2024
Certification dateSeptember 3, 2024

Medicare enrollment

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

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2023 (3 years in practice)
Group practice Saint Alphonsus Regional Medical Center Inc — 673 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations7 on file with Medicare

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