Independent US Healthcare Provider Directory & Public Medical Database
Active NPI 1184392011 Individual Practitioner Male Practitioner

Cody Johnson

Physician Assistant • Boise, ID

✓ Accepts Medicare Assignment Telehealth Available

Professional Overview & Biography Verified Profile Summary

Cody Johnson is a certified Physician Assistant practicing in Boise, ID. With approximately 5 years of clinical experience since completing medical education in 2021, Cody Johnson delivers high-quality medical care to the local community at 190 E BANNOCK ST FL 10.

Cody Johnson is affiliated with St Lukes Clinic-Treasure Valley Llc and accepts Medicare assignment . Telehealth and virtual consultation options are available for eligible patients.

Frequently performed procedures and clinical services include established patient outpatient office visit, creation of muscle graft to trunk, new patient outpatient office visit. Full Medicare procedure pricing transparency rates and service volume details are listed on this profile.

Practice Location & Contact Primary Location

Practice Address

190 E Bannock St Fl 10

Boise, ID 837126241

Telephone 2083815500
Associated Practice Facility / Clinic

Medicare Profile & Education

Medical School

Other

Graduation Year

2021

Medicare Assignment

✓ Accepts Assignment

Telehealth Flag

Telehealth Services Available

Specialty Benchmarks & Practice Insights

Comparative analytics for Physician Assistant in Boise, ID

Experienced Practitioner (5-10 Yrs)
Practitioner Clinical Experience
5 Yrs -5.1 yrs vs City Avg
City Avg: 10.1 Yrs
State Avg: 12.4 Yrs
Regional Practice Density
364 Specialists

Practicing in Boise, ID (1261 Statewide)

Telehealth Adoption Rate
12.4% Regional Adoption

✓ Offers Virtual Consultations

Medicare Pricing Discount
65.0% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Clinical Seniority & Experience Comparison

Dr. Johnson (5 Years) 5 Yrs
Boise Specialty Average (10.1 Years) 10.1 Yrs

Performed Procedures & Service Volume

Top Medicare Part B procedures performed by this practitioner

CMS Official Data (2024)
Reporting Year:
HCPCS Code & Description Services Patients Submitted Charge Medicare Allowed
99213 Established patient office or other outpatient visit, typically 15 minutes
19 16 $147.16 $51.44

Medical Specialties & State Licenses

CMS Verified: 2022-11-30
Physician Assistant Primary Specialty

NUCC Taxonomy Code: 363A00000X

State License ID PA-2399

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.

Physician Assistant

NUCC Taxonomy Code: 363A00000X

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.

Hospital & Practice Group Affiliations

St Lukes Clinic-Treasure Valley Llc

608 W Hays St, Boise, ID 837025511

Phone: 2083815970

St Lukes Clinic-Treasure Valley Llc

100 E Bannock St, Boise, ID 837126241

Phone: 2083812983

St Lukes Clinic-Treasure Valley Llc

610 W Hays St, Boise, ID 837025511

Phone: 2083815970

St Lukes Clinic-Treasure Valley Llc

190 E Bannock St, Boise, ID 837126241

Phone: 2083819384

Secondary Practice Locations

407 S Schwartz Ave Ste 101

Farmington, NM 874015925

Phone: 5056096595

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

23 Associated Practitioners
Dr. Kenneth Little , MD

Neurological Surgery

NPI 1023039468

Doctor of Medicine (M.D.)

Dr. David Bray , MD

Neurological Surgery

NPI 1114381142

Doctor of Medicine (M.D.)

David Nielson , PA-C

Physician Assistant

NPI 1124393939

Physician Assistant (Certified)

Kimberly Mrozek , PA-C

Physician Assistant - Medical

NPI 1164985867

Physician Assistant (Certified)

Alec Meyerhoeffer

Physician Assistant

NPI 1184322513
Angela Apreotesi

Physician Assistant

NPI 1184352213

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

10 Historical Events
📍
Updated Practice Location November 30, 2022

Registered at 190 E BANNOCK ST FL 10, BOISE, ID 837126241 (Tel: 2083815500)

📍
Updated Business Mailing Address November 30, 2022

Registered at 190 E BANNOCK ST, BOISE, ID 837126241

📍
Updated Practice Location December 10, 2021

Registered at 407 S SCHWARTZ AVE STE 101, FARMINGTON, NM 874015925 (Tel: 5056096595)

📍
Updated Business Mailing Address December 10, 2021

Registered at PO BOX 6210, FARMINGTON, NM 874996210

NPI Profile Active September 03, 2021

NPI status registered as active in NPPES database

📍
Updated Practice Location September 03, 2021

Registered at 1457 W BEAR TRACK DR, MERIDIAN, ID 836424454 (Tel: 2086296079)

📍
Updated Business Mailing Address September 03, 2021

Registered at 1457 W BEAR TRACK DR, MERIDIAN, ID 836424454 (Tel: 2086296079)

👤
Provider Name / Credentials Updated September 03, 2021

Recorded as CODY JOHNSON

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) September 03, 2021

Physician Assistant

🟢
Initial NPI Registration & Enumeration September 03, 2021

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1184392011
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: September 03, 2021
Last Update: November 30, 2022
Sole Proprietor: No

Mailing Address

190 E Bannock St

Boise, ID 837126241

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.