MR. JUDE BOUTKASKA (NPI# 1801948591) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1801948591 |
| Entity Type | Individual |
| Full Name | MR. JUDE BOUTKASKA |
| Credential | PA |
| Practice Address |
413 Allumbaugh St Suite 101 Boise ID 83704-9212 |
| Practice Telephone | 2083626162 |
| Practice Fax Number | 2083629604 |
| Mailing Telephone | 2083626162 |
| Mailing Fax Number | 2083629604 |
| Enumeration Date | 2007-01-16 |
| Last Update Date | 2008-02-29 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363AM0700X |
Physician Assistant Specialization: Medical |
PA343 | ID | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
413 ALLUMBAUGH ST SUITE 101 |
| City | BOISE |
| State | ID |
| Zip Code | 83704-9212 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1821038704 | Michael Bryan Loegering | Nurse Practitioner | 413 Allumbaugh St, Suite 101, Boise, ID 83704-9212 | 2006-06-07 |
| 1447495114 | Eric Gilbreath Md Pa | Psychologist | 413 Allumbaugh St, Ste 101, Boise, ID 83704-9212 | 2008-12-10 |
| 1699893487 | Summit Counseling Pllc | Counselor | 413 Allumbaugh St, Suite 102, Boise, ID 83704-9212 | 2007-03-27 |
| 1114057528 | Amy Ann Miles | Social Worker | 413 Allumbaugh St, 102, Boise, ID 83704-9212 | 2007-03-06 |
| 1306974365 | Laurisa Rogers Lusby | Social Worker | 413 Allumbaugh St, Ste 102, Boise, ID 83704-9212 | 2007-03-01 |
| 1750418844 | Margaret N Callens | Social Worker | 413 Allumbaugh St, Suite 102, Boise, ID 83704-9212 | 2007-02-27 |
| 1922133719 | Brian H Green | Counselor | 413 Allumbaugh St, Suite 102, Boise, ID 83704-9212 | 2007-02-22 |
| 1154467629 | Christine Jue | Physical Therapist | 413 Allumbaugh St, Ste 102, Boise, ID 83704-9212 | 2007-01-30 |
| 1760534424 | Manisha Mittal | Internal Medicine | 413 Allumbaugh St, Ste 101, Boise, ID 83704-9212 | 2007-01-16 |
| 1750447173 | Laura S Shockley | Counselor | 413 Allumbaugh St, Suite 101, Boise, ID 83704-9212 | 2006-12-29 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215535893 | Laura Diggs | Counselor | 400 North Benjamin Lane, Suite 200, Boise, ID 83704 | 2020-10-15 |
| 1891304002 | Tree City Family Dental | Dentist | 7301 W. Emerald St Ste. 102, Boise, ID 83704 | 2020-07-24 |
| 1982230710 | Jessica Wynn Councell | Midwife | 1072 N Liberty St Ste 100, Boise, ID 83704 | 2020-03-12 |
| 1699307124 | Isabel Burns Bruce | Registered Nurse | 777 N Raymond Street, Boise, ID 83704 | 2020-02-12 |
| 1558903328 | Daring In Idaho, LLC | Social Worker | 413 N Allumbaugh Street, Suite 102, Boise, ID 83704 | 2019-10-14 |
| 1053960286 | Kyle Hiromi Hatanaka | Acupuncturist | 9450 #120 Fairview Avenue, Boise, ID 83704 | 2019-09-10 |
| 1700447141 | Katie Elizabeth Nichols | Physician Assistant | 1072 N Liberty St Ste 201, Boise, ID 83704 | 2019-06-26 |
| 1588164727 | Cory Michael Sims | Counselor | 6550 W. Emerald St #112, Boise, ID 83704 | 2018-02-14 |
| 1477072270 | Matthew Lee Love | Non-emergency Medical Transport (VAN) | 6933 W. Stratton St, Boise, ID 83704 | 2017-09-12 |
| 1942735949 | Dalana Sue Thompson | Counselor | 9196 Emerald St Suite #130, Boise, ID 83704 | 2017-04-27 |
| Find all providers in zip 83704 | ||||
| Taxonomy Code | 363AM0700X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| Specialization | Medical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1073915963 | Jessica Bishop | Physician Assistant | 1499 W Hays St, Boise, ID 83702-5029 | 2014-09-23 |
| 1508287061 | Heather N Fox | Physician Assistant | 12273 West Mcmillan Road, Boise, ID 83713 | 2013-12-30 |
| 1710231238 | Alaina A Mccoy | Physician Assistant | 100 E. Idaho St., Suite 400, Boise, ID 83712 | 2012-11-06 |
| 1447534821 | Addie Barnes | Physician Assistant | 900 N Liberty, Ste 101, Boise, ID 83704 | 2011-10-04 |
| 1134358104 | Eric Culbertson | Physician Assistant | 633n 4th St, Boise, ID 83702-4510 | 2009-07-10 |
| 1790923621 | Christie Dudash Flynn | Physician Assistant | 12273 W Mcmillian Road, Boise, ID 83713 | 2009-01-30 |
| 1598921595 | Karen B. Barrett | Physician Assistant | 6000 W. Overland Road, Firstline Medical, Boise, ID 83704 | 2008-07-30 |
| 1972672111 | Kara Mcgee | Physician Assistant | 727 E Riverpark Ln Ste 200, Boise, ID 83706-4097 | 2006-11-06 |
| 1265464036 | Sharene E Watsen | Physician Assistant | 403 South 11th St, Ste 100, Boise, ID 83702-6906 | 2006-07-06 |
| 1508802091 | Heidi R Munro | Physician Assistant | 8000 S Federal Way, Boise, ID 83716-9632 | 2006-06-22 |
| Find all providers in BOISE | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.