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

Stanford Benjamin Gammon, PA

Individual provider Surgical Physician Assistant · NPI 1477992592

Stanford Benjamin Gammon, PA is a Physician Assistant in Idaho Falls, Idaho. Qualified in 2013, 13 years ago. Practices with Idaho Physician Services Inc, an 18-clinician group and accepts Medicare assignment. Licensed in Idaho.

Years since qualifying
13
Licensed in
ID
In the registry since
2013
What do these letters mean?
PA — Physician Assistant
A licensed clinician who examines, diagnoses and treats under a physician's supervision.

See every abbreviation used in this directory →

Practice location Address checks out

3345 Potomac Way
Idaho Falls, ID 83404-4978
Phone: (208) 552-7572
Fax: (208) 552-7312
Show map & directions

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

Specialties & licences

Surgical Physician Assistant (primary) Taxonomy 363AS0400X · Licence PA-1328 (ID)

Record details

NPI number1477992592
Entity typeIndividual (Type 1)
GenderMale
Credentials PA
Sole proprietorNo
NPI enumeratedJune 21, 2013
Last updated in NPPESJuly 7, 2022
Certification dateJuly 7, 2022

Medicare enrollment

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

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2013 (13 years in practice)
Group practice Idaho Physician Services Inc — 18 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations5 on file with Medicare

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