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

Tyson Darrell Greener, PA-C

Individual provider Surgical Physician Assistant · NPI 1356123863

Tyson Darrell Greener, PA-C is a Physician Assistant in Burley, Idaho. Qualified in 2024, 2 years ago. Practices with Minidoka Memorial Hospital, a 39-clinician group, works from 2 locations and accepts Medicare assignment. Licensed in Idaho.

Years since qualifying
2
Licensed in
ID
In the registry since
2023
Specialties on file
2
What do these letters mean?
PA-C — Physician Assistant, Certified
A physician assistant who holds current national certification.

See every abbreviation used in this directory →

Practice location Address checks out

260 E 5th St N
Burley, ID 83318-3453
Phone: (208) 678-9760
Fax: (208) 678-9758
Show map & directions

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

Additional practice locations (1)

  • 1224 8th St, Rupert, ID 83350-1599 — (208) 436-0481

Specialties & licences

Surgical Physician Assistant (primary) Taxonomy 363AS0400X · Licence 6571244 (ID)
Physician Assistant Taxonomy 363A00000X

Record details

NPI number1356123863
Entity typeIndividual (Type 1)
GenderMale
Credentials PA-C
Sole proprietorYes
NPI enumeratedOctober 18, 2023
Last updated in NPPESFebruary 7, 2025
Certification dateFebruary 5, 2025
Mailing address684 E 400 N, Rupert, ID 83350-9460

Medicare enrollment

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

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2024 (2 years in practice)
Group practice Minidoka Memorial Hospital — 39 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount