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

Tea Hasanovic, PA-C

Individual provider Physician Assistant · NPI 1073119780

Tea Hasanovic, PA-C is a Physician Assistant in Fruitland, Idaho. Qualified in 2020, 6 years ago. Practices with Snake River Dermatology, PA, a 4-clinician group, works from 3 locations and accepts Medicare assignment. Licensed in Idaho.

Years since qualifying
6
Licensed in
ID
In the registry since
2020
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

2101 N Whitley Dr
Fruitland, ID 83619-2132
Phone: (208) 452-5999
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (2)

  • 1623 S Wells Ave, Meridian, ID 83642-5040 — (208) 489-1450
  • 11211 W Hercules Dr, Star, ID 83669-5074 — (208) 286-4254

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence PA-1978 (ID)

Record details

NPI number1073119780
Entity typeIndividual (Type 1)
GenderFemale
Credentials PA-C
Sole proprietorYes
NPI enumeratedDecember 8, 2020
Last updated in NPPESApril 17, 2023
Certification dateApril 17, 2023
Mailing address2101 N Whitley Dr, Fruitland, ID 83619-2132

Medicare enrollment

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

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2020 (6 years in practice)
Group practice Snake River Dermatology, Pa — 4 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations2 on file with Medicare

Other providers in Fruitland