RILEE WONG MICKELSEN PA-C
NPI 1770346835
Physician Assistant - Surgical in Boise, ID
NPI Status: Active since February 01, 2024
Contact Information
1072 N LIBERTY ST STE 201
BOISE, ID
ZIP 83704
Phone: (208) 302-2400
Fax: (208) 302-2455
- Individual
- Female
- Physician Assistant
- Surgical
- PECOS Enrolled
About RILEE MICKELSEN
This page provides the complete NPI Profile along with additional information for Rilee Mickelsen, a provider established in Boise, Idaho with a medical specialization in Physician Assistant, focusing in surgical . The healthcare provider is registered in the NPI registry with number 1770346835 assigned on February 2024. The practitioner's primary taxonomy code is 363AS0400X with license number 8061671 (ID). The provider is registered as an individual and her NPI record was last updated one year ago.
- NPI
- 1770346835
- Provider Name
- RILEE WONG MICKELSEN PA-C
- Gender
- Female
- Entity Type
- Individual
- Location Address
- 1072 N LIBERTY ST STE 201 BOISE, ID 83704
- Location Phone
- (208) 302-2400
- Location Fax
- (208) 302-2455
- Mailing Address
- PO BOX 190930 BOISE, ID 83719
- Mailing Phone
- (208) 367-5170
- Mailing Fax
- (208) 302-2455
- Is Sole Proprietor?
- No
- Enumeration Date
- 02-01-2024
- Last Update Date
- 09-03-2024
- Code Navigator
Location Map
Secondary Locations
- 111 S 11th St Ste 8290
Philadelphia, PA 19107
(215) 955-6161
Specialty - Primary Taxonomy
The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
- Classification
Physician Assistant Surgical
- Taxonomy Code
- 363AS0400X
- Type
- Physician Assistants & Advanced Practice Nursing Providers
- License No.
- 8061671
- License State
- ID
Secondary Taxonomies
The provider has reported to the NPI enumerator additional taxonomy codes. Multiple taxonomy codes may represent subspecialties or other areas of specialization the provider maybe licensed to practice.
| No. | Taxonomy Code | Type | Classification / Specialization |
License No. (State) |
|---|---|---|---|---|
| 1 | 363AM0700X | Physician Assistants & Advanced Practice Nursing Providers | Physician Assistant | MA065365 (PA) |
| 2 | 363AS0400X | Physician Assistants & Advanced Practice Nursing Providers | Physician Assistant | MA065365 (PA) |
Medicare Participation & PECOS Enrollment Status
Rilee Mickelsen is enrolled in PECOS and is eligible to order or refer health care services for Medicare patients. The provider is eligible to order or refer: Part B Clinical Laboratory and Imaging, Durable Medical Equipment (DME), a Home Health Agency (HHA) and Power Mobility Devices.
What is PECOS?
PECOS is the online Medicare enrollment management system or Provider, Enrollment, Chain and Ownership System. The PECOS system is a database of providers who have registered with CMS as providers or suppliers. PECOS is the primary source of information about verified Medicare professionals. Providers that want to participate in this program need to enroll in PECOS with their NPI number to avoid denied claims.
Is the provider registered in PECOS? Yes
Eligible to Order or Refer Part B Clinical Laboratory and Imaging: Yes
Eligible to Order or Refer Durable Medical Equipment (DMEPOS): Yes
Eligible to Order or Refer a Home Health Agency (HHA): Yes
Eligible to Order or Refer Power Mobility Devices: Yes
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NPI Validation Check Digit Calculation
The following table explains the step by step NPI number validation process using the ISO standard Luhn algorithm.
| Start with the original NPI number, the last digit is the check digit and is not used in the calculation. | |||||||||
| 1 | 7 | 7 | 0 | 3 | 4 | 6 | 8 | 3 | 5 |
| Step 1: Double the value of the alternate digits, beginning with the rightmost digit. | |||||||||
| 2 | 7 | 14 | 0 | 6 | 4 | 12 | 8 | 6 | |
| Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24. | |||||||||
| 2 + 7 + 1 + 4 + 0 + 6 + 4 + 1 + 2 + 8 + 6 + 24 = 65 | |||||||||
| Step 3: Subtract the total obtained in step 2 from the next higher number ending in zero, the result is the check digit. | |||||||||
| 70 - 65 = 5 | 5 | ||||||||
The NPI number 1770346835 is valid because the calculated check digit 5 using the Luhn validation algorithm matches the last digit of the original NPI number.
Other Providers at the Same Location
The following 6 providers are registered at the same or nearby location.
| NPI | Name / Type | Taxonomy | Address |
|---|---|---|---|
| 1447966213 | KELSY REID PATRICK PA-C Individual | Physician Assistant | 1072 N LIBERTY ST STE 201 BOISE, ID 83704 (208) 302-2400 |
| 1760914345 | HUGO CESAR ARAUJO LINO Individual | Surgery | 1072 N LIBERTY ST STE 201 BOISE, ID 83704 (208) 302-2400 |
| 1043943442 | SHANNON BURKE PA-C Individual | Physician Assistant | 1072 N LIBERTY ST STE 201 BOISE, ID 83704 (208) 302-2400 |
| 1205193760 | ANTHONY DINALLO Individual | Surgery | 1072 N LIBERTY ST STE 201 BOISE, ID 83704 (208) 302-2400 |
| 1477208791 | JENNIFER N PERKINS PA-C Individual | Physician Assistant | 1072 N LIBERTY ST STE 201 BOISE, ID 83704 (208) 302-2400 |
| 1215660477 | MELISSA ROSE WEST Individual | Physician Assistant | 1072 N LIBERTY ST STE 201 BOISE, ID 83704 (208) 302-2700 |
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1770346835, enumerated in the NPI registry as an "individual" on February 01, 2024
The provider is located at 1072 N Liberty St Ste 201 Boise, Id 83704 and the phone number is (208) 302-2400
The provider's speciality is Physician Assistant with taxonomy code 363AS0400X with a focus in Surgical
Yes, as of June 20, 2025 the provider is registered in PECOS and is eligible to order health care services or supplies for Medicare patients. If you are a beneficiary the provider is eligible to order or refer: Part B Clinical Laboratory and Imaging, Durable Medical Equipment (DME), a Home Health Agency (HHA) and Power Mobility Devices.
This NPI record was last updated on February 01, 2024. To officially update your NPI information contact the National Plan and Provider Enumeration System (NPPES) at 1-800-465-3203 (NPI Toll-Free) or by email at [email protected].
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