Look up the most recent NPI and PECOS records

Kacey Blea

Physician Assistant

Physician Assistants & Advanced Practice Nursing Providers

PECOS Enrollment

Based on the most recent information from CMS, provider Kacey Blea is legally eligible to order and refer claims for Part B, HHA, DME and PMD services.

Part B
Medicare Part B
Enrolled
HHA
Home Health Agency
Enrolled
DME
Durable Medical Equipment
Enrolled
PMD
Power Mobility Device
Enrolled

CMS last updated its PECOS records yesterday at 9:43 AM.

Profile Details

Provider ID
1205561727
Provider Type
Individual
Full Name
Blea, Kacey
Gender
Female

Sole Proprietor
No
Enumeration Date
7/19/2022
Last Updated
1/17/2024

Contact Information

Practice Location

100 E Idaho St, Boise, ID 83712-6267

(208) 381-4171

(208) 381-4172

Mailing Location

190 E Bannock St, Boise, ID 83712-6241

(208) 381-8749

Unlisted Fax

Provider Taxonomies

Code	Description	License
Code 363A00000X Primary	Description Physician Assistant Physician Assistants & Advanced Practice Nursing Providers	License PA-2652 Idaho
Code 390200000X	Description Student in an Organized Health Care Education/Training Program Student, Health Care	License Unlisted Issuer
Code 363A00000X	Description Physician Assistant Physician Assistants & Advanced Practice Nursing Providers	License 1214536 Idaho

Kacey Blea

PECOS Enrollment

Profile Details

Contact Information

Practice Location

Mailing Location

Provider Taxonomies

Code

Description

License

Code

Description

License

Code

Description

License

Code

Description

License

Fritz, Lyndsey

Porter, Robert William

Pons, Adriana Elizabeth

Kehlenbrink, Angela M

Joly, Celeste

Ambrosier, Amy M

Giles, Thomas Ryan

Neisen, Misty

Hague, Natalie Marie

Jessup, Alice Rachel