Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Sean P Hackett, PA-C

Individual provider Medical Physician Assistant · NPI 1881685642

Sean P Hackett, PA-C is a Physician Assistant in Fruitland, Idaho. Qualified in 1997, 29 years ago. Practices with St Lukes Clinic-Treasure Valley LLC, a 1,150-clinician group and accepts Medicare assignment. Licensed in Idaho and Oregon.

Years since qualifying
29
Licensed in
ID, OR
In the registry since
2005
Specialties on file
2
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

1210 NW 16th St
Fruitland, ID 83619-2202
Phone: (208) 452-8600
Fax: (208) 452-8601
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Medical Physician Assistant (primary) Taxonomy 363AM0700X · Licence PA-204 (ID)
Medical Physician Assistant Taxonomy 363AM0700X · Licence PA00575 (OR)

Record details

NPI number1881685642
Entity typeIndividual (Type 1)
GenderMale
Credentials PA-C
Sole proprietorNo
NPI enumeratedNovember 2, 2005
Last updated in NPPESMarch 16, 2011
Mailing address190 E Bannock St, Boise, ID 83712-6241

Medicare enrollment

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

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 1997 (29 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

Other providers in Fruitland