JONATHAN SUBAITANI (NPI# 1821529918) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1821529918 |
| Entity Type | Individual |
| Full Name | JONATHAN SUBAITANI |
| Credential | PA-C |
| Practice Address |
11197 W Fairview Ave Boise ID 83713 |
| Mailing Address |
Po Box 191050 Boise ID 83719-1050 |
| Practice Telephone | 2083788011 |
| Mailing Telephone | 2089556500 |
| Enumeration Date | 2017-03-21 |
| Last Update Date | 2018-06-27 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207PE0004X |
Emergency Medicine Specialization: Emergency Medical Services |
0110005599 | VA | Allopathic & Osteopathic Physicians |
| Y | 363A00000X | Physician Assistant | PA-1596 | ID | Physician Assistants & Advanced Practice Nursing Providers |
| N | 363A00000X | Physician Assistant | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
11197 W FAIRVIEW AVE |
| City | BOISE |
| State | ID |
| Zip Code | 83713 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053385054 | Phillip Brian Whittenberg | Physician Assistant | 11197 W Fairview Ave, Boise, ID 83713-7935 | 2006-02-15 |
| 1073083440 | Alishia Little | Physician Assistant | 11197 W Fairview Ave, Boise, ID 83713-7935 | 2018-11-28 |
| 1558735514 | Samuel Shinkle | Physician Assistant | 11197 W Fairview Ave, Boise, ID 83713-7935 | 2015-11-13 |
| 1538505276 | Abby M. Luensmann | Family Medicine | 11197 W Fairview Ave, Boise, ID 83713-7935 | 2013-05-21 |
| 1467787598 | Jenna Lynn Maffey | Physician Assistant | 11197 W Fairview Ave, Boise, ID 83713-7935 | 2009-10-07 |
| 1316183601 | Alliance Medical Group, LLC | Family Medicine | 11197 W Fairview Ave, Boise, ID 83713-7935 | 2008-12-17 |
| 1942219233 | Larry Michael Oborn | Physician Assistant | 11197 W Fairview Ave, Boise, ID 83713-7935 | 2006-08-05 |
| 1386664654 | Ryan A Moore | Family Medicine | 11197 W Fairview Ave, Boise, ID 83713-7935 | 2006-07-20 |
| 1215972831 | Jennifer M Vincent | Family Medicine | 11197 W Fairview Ave, Boise, ID 83713-7935 | 2006-06-18 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1265902332 | Kidscare Home Health of Idaho, LLC | Home Health | 1835 Wildwood Street, Boise, ID 83713 | 2018-11-30 |
| 1417463928 | Kimberly Ann Bohrer | Behavioral Analyst | 12053 W Hickory Dr, Boise, ID 83713 | 2017-12-19 |
| 1407371891 | Emir Hadzic | Optometrist | 13239 W. Fernleaf St., Boise, ID 83713 | 2017-08-07 |
| 1518336650 | Alliance Physical Medicine | Nurse Practitioner | 13909 W Wainwright Drive, Boise, ID 83713 | 2015-09-18 |
| 1083038335 | Jan L Rehder | Nurse Practitioner | 13150 W Persimmon Lane, Boise, ID 83713 | 2014-02-06 |
| 1508287061 | Heather N Fox | Physician Assistant | 12273 West Mcmillan Road, Boise, ID 83713 | 2013-12-30 |
| 1659667459 | Jayson Clark | Dentist | 4274 N Eagle Road, Boise, ID 83713 | 2011-06-21 |
| 1043503659 | Steven Anthony Eckhoff | Physician Assistant | 11662 W Arlen St, Boise, ID 83713 | 2011-05-16 |
| 1790923621 | Christie Dudash Flynn | Physician Assistant | 12273 W Mcmillian Road, Boise, ID 83713 | 2009-01-30 |
| 1699930404 | Dennis J. Garpetti, Dds, P.C. | Dentist | 13108 West Persimmon Lane, Boise, ID 83713 | 2008-07-21 |
| Find all providers in zip 83713 | ||||
| Taxonomy Code | 363A00000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1821695792 | Chelsea Dylan Tennent | Physician Assistant | 1666 E Gentlewind St, Boise, ID 83706-5914 | 2020-10-05 |
| 1871114553 | Samantha Tess Goodrich | Physician Assistant | 721 E Lenz St, Boise, ID 83712-7846 | 2020-05-04 |
| 1689131005 | Aftin Jade Martens | Physician Assistant | 303 N Allumbaugh St, Boise, ID 83704-9208 | 2019-02-21 |
| 1215418140 | Michael Edward Molnar | Physician Assistant | 2012 S Longmont Ave, Boise, ID 83706-4235 | 2018-08-28 |
| 1578059143 | Mckenzie Hart | Physician Assistant | 4334 S Aleut Way, Boise, ID 83709-6033 | 2018-07-07 |
| 1174035638 | Zacharia Njoroge | Physician Assistant | 1055 N Curtis Rd 6th Floor, Boise, ID 83706 | 2017-10-24 |
| 1073040242 | Nicole Ankenbrandt | Physician Assistant | 3151 S Terra Dr, Boise, ID 83709-3831 | 2017-05-17 |
| 1346792033 | Samantha Rae Lange | Physician Assistant | 1072 N Liberty St Ste 203, Boise, ID 83704 | 2016-10-27 |
| 1174070098 | Alexandra W Clapp | Physician Assistant | 6140 West Curtisian Avenue Suite 200, Boise, ID 83704 | 2016-09-08 |
| 1376914838 | Morgan Grace Roskelley | Physician Assistant | 703 S. Americana Blvd, Ste 120, Boise, ID 83702 | 2015-10-09 |
| 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.