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

Individual provider Physician Assistant · NPI 1780352666

Trevor Peterson, PA-C is a Physician Assistant in Boise, Idaho. Qualified in 2022, 4 years ago. Practices with Full Circle Health Inc, a 109-clinician group and accepts Medicare assignment. Licensed in Oregon.

Years since qualifying
4
Licensed in
OR
In the registry since
2021
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

777 N Raymond St
Boise, ID 83704-9251
Phone: (208) 514-2500
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence PA213384 (OR)
Student in an Organized Health Care Education/Training Program Taxonomy 390200000X

Record details

NPI number1780352666
Entity typeIndividual (Type 1)
GenderMale
Credentials PA-C
Sole proprietorYes
NPI enumeratedSeptember 3, 2021
Last updated in NPPESAugust 7, 2024
Certification dateAugust 7, 2024

Medicare enrollment

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

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2022 (4 years in practice)
Group practice Full Circle Health Inc — 109 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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