| Charisse L Mack, PA | |
|
6140 Curtisian Ave, Ste 400, Boise, ID 83704-8880 | |
| (208) 367-3500 | |
| (208) 367-2968 |
| Full Name | Charisse L Mack |
|---|---|
| Gender | Female |
| Speciality | Physician Assistant |
| Experience | 18 Years |
| Location | 6140 Curtisian Ave, Boise, Idaho |
| Accepts Medicare Assignments | Yes. She accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1801973615 | NPI | - | NPPES |
| 0214786 | Other | ID | STATE OF WA DOL |
| PAD65 | Other | ID | BLUE CROSS OF ID |
| 000010158697 | Other | ID | BLUE SHIELD OF ID |
| 807590500 | Medicaid | ID |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 363A00000X | Physician Assistant | PA-632 (Idaho) | Primary |
| 363AS0400X | Physician Assistant - Surgical | PA632 (Idaho) | Secondary |
| Facility Name | Location | Facility Type |
|---|---|---|
| St Luke's Regional Medical Center | Boise, ID | Hospital |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| St Lukes Clinic-treasure Valley Llc | 4981878402 | 991 |
| Mailing Address | Practice Location Address |
|---|---|
| Charisse L Mack, PA 190 E Bannock St, Boise, ID 83712-6241 Ph: (208) 381-2222 | Charisse L Mack, PA 6140 Curtisian Ave, Ste 400, Boise, ID 83704-8880 Ph: (208) 367-3500 |
Brittany Guthrie, PA-C Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 1072 N Liberty Street, Ste 303, Boise, ID 83704 Phone: 208-302-4400 Fax: 208-302-4255 | |
Polina Kokoulina, PA-C Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 900 N Liberty St, Ste 101, Boise, ID 83704 Phone: 208-367-5050 Fax: 208-367-5151 | |
Natalie Marie Hague, PA Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 100 E Warm Springs Ave Ste B, Boise, ID 83712 Phone: 208-381-6930 Fax: 208-381-6931 | |
Micah Ray Tobin, PA Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 10583 W Lake Hazel Rd, Boise, ID 83709 Phone: 208-302-5950 Fax: 208-302-5955 | |
Jason H. Mcbride, PA-C Physician Assistant Medicare: Medicare Enrolled Practice Location: 1055 N Curtis Rd, Boise, ID 83706 Phone: 208-367-3131 | |
Patrick B Mccabe, PA-C Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 1188 W University Dr, Boise, ID 83706 Phone: 208-336-8250 Fax: 208-345-9514 | |
Thomas F Douthit, PA-C Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 900 N. Liberty St., Suite 400, Boise, ID 83704 Phone: 208-367-3320 Fax: 208-367-7474 |