Samantha Anne McCain
Physician Assistant in Boise, ID. Individual provider (NPI-1).
NPI number1477286201
StatusActive
Last updated in NPPESDec 5, 2024
Details
- NPI
- 1477286201
- Entity type
- Individual (NPI-1)
- Name
- Samantha Anne McCain
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Jul 8, 2022
- Certification date
- Dec 5, 2024
- Last updated
- Dec 5, 2024
Medicare and OIG
- Medicare enrolled (PECOS)
- Yes · PRACTITIONER - PHYSICIAN ASSISTANT
- Can order and refer
- Part B Yes · DME Yes · Home health Yes · Power mobility Yes · Hospice No
- OIG exclusion list
- This NPI is not listed
CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 363A00000X | Physician Assistant | 8761978 | ID | Yes |
| 363A00000X | Physician Assistant | – | – |
Practice location
6051 W Emerald StBoise, ID 83704-8969
Phone 208-302-5150 · Fax 208-302-5155
Mailing address
Po Box 190930Boise, ID 83719-0930
Phone 208-302-9342 · Fax 208-367-5180
Other practice locations
921 S 8th Ave Stop 8253
Pocatello, ID 83209-0002
Pocatello, ID 83209-0002
Phone 208-282-4726
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This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.
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