SUSAN E PAYTASH (NPI# 1912073370) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1912073370 |
| Entity Type | Individual |
| Full Name | SUSAN E PAYTASH |
| Credential | PA |
| Practice Address |
1673 W Shoreline Dr Suite 120 Boise ID 83702-6749 |
| Mailing Address |
3340 E Goldstone Way Meridian ID 83642-1026 |
| Practice Telephone | 2083678383 |
| Practice Fax Number | 2084298310 |
| Mailing Telephone | 2083675170 |
| Mailing Fax Number | 2083675180 |
| Enumeration Date | 2006-11-28 |
| Last Update Date | 2013-02-20 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 363AM0700X |
Physician Assistant Specialization: Medical |
PA-596 | ID | Physician Assistants & Advanced Practice Nursing Providers |
| Y | 363AM0700X |
Physician Assistant Specialization: Medical |
PA596 | ID | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| ID | 807392700 | 05 |
| Street Address |
1673 W SHORELINE DR SUITE 120 |
| City | BOISE |
| State | ID |
| Zip Code | 83702-6749 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1467466201 | Frank Culbertson | Physical Therapist | 1673 W Shoreline Dr, Suite 230, Boise, ID 83702 | 2006-07-28 |
| 1649556325 | Pain Center, Inc. | Non-Pharmacy Dispensing Site | 1673 W Shoreline Dr, Ste 140, Boise, ID 83702-6750 | 2011-10-26 |
| 1760798375 | Bret A Bastian | Physical Therapist | 1673 W Shoreline Dr, Suite 230, Boise, ID 83702-6750 | 2010-08-20 |
| 1245494269 | James Hammer | Physical Therapist | 1673 W Shoreline Dr, Sutie 230, Boise, ID 83702-6750 | 2008-07-18 |
| 1730356510 | Tommy Jo Brunelle | Physical Therapist | 1673 W Shoreline Dr, Ste 230, Boise, ID 83702-6750 | 2008-05-12 |
| 1578633384 | Tobie Strong | Physical Therapist | 1673 W Shoreline Dr, Suite 230, Boise, ID 83702-6750 | 2006-11-09 |
| 1275603086 | Lisa M. Swan | Physical Therapist | 1673 W Shoreline Dr, Suite 230, Boise, ID 83702-6750 | 2006-11-09 |
| 1811066558 | Debra F Marquez | Physical Therapist | 1673 W Shoreline Dr, Suite 230, Boise, ID 83702 | 2006-11-07 |
| 1982611836 | Jason Brooks Aberg | Physical Therapist | 1673 W Shoreline Dr, Suite 230, Boise, ID 83702 | 2006-08-02 |
| 1790792646 | Nick L Woods | Physical Therapist | 1673 W Shoreline Dr, Suite 230, Boise, ID 83702 | 2006-08-02 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790321966 | Inland Northwest Neuromonitoring Pllc | Psychiatry & Neurology | 950 Bannock Street, Suite 1100, Boise, ID 83702 | 2019-11-22 |
| 1508359084 | Emily Cook | Dietitian, Registered | St. Luke's Rehab Hospital, 600 N Robbins Road, Bosie, ID 83702 | 2018-06-11 |
| 1265925887 | Marla Braendle | Dietitian, Registered | St. Luke's Rehabilitation Hospital, 600 N. Robbins Road, Boise, ID 83702 | 2018-06-08 |
| 1114419678 | Sidrah Khan Psychotherapy PC | Social Worker | 242 N 8th St, Suite 200, Boise, ID 83702 | 2018-05-31 |
| 1508386707 | Emp Idaho Nampa, LLC | General Acute Care Hospital | 350 E Myrtle Street, Suite 100, Boise, ID 83702 | 2017-06-20 |
| 1194264077 | Karen Mangum | Dietitian, Registered | 115 N. Main Street, Suite #203, Boise, ID 83702 | 2017-02-13 |
| 1750828422 | Stephen Pyper | Massage Therapist | 14089 Main St #100, Boise, ID 83702 | 2017-01-19 |
| 1427504398 | The Young Mens Christian Association of Boise City Idaho | Health Educator | 419 N 11th St, Boise, ID 83702 | 2016-08-30 |
| 1942756838 | Brent Hiroshi Sasaki | Pharmacist | 500 West Fort Street (119), Boise, ID 83702 | 2016-08-30 |
| 1578912051 | Marnae Walker | Counselor | 509 S. 14th St, Suite 2, Boise, ID 83702 | 2016-06-06 |
| Find all providers in zip 83702 | ||||
| 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.