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Susan Marie Schram

Physician Assistant

Physician Assistants & Advanced Practice Nursing Providers

125 E Idaho St Ste 100, Boise, ID 83712-6202

PECOS Enrollment

This provider is enrolled in PECOS as SUSAN SCHRAM.

Based on the most recent information from CMS, provider Susan Marie Schram 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
1477071447
Provider Type
Individual
Full Name
Schram, Susan Marie
Credential
PA-C

Gender
Female
Sole Proprietor
No
Enumeration Date
8/30/2017
Last Updated
12/7/2023

Contact Information

Practice Location

125 E Idaho St Ste 100, Boise, ID 83712-6202

(208) 338-0148

(208) 336-4027

Mailing Location

190 E Bannock St, Boise, ID 83712-6241

Unlisted Phone

Unlisted Fax

Provider Taxonomies

Code	Description	License
Code 363A00000X Primary	Description Physician Assistant Physician Assistants & Advanced Practice Nursing Providers	License 2102 Idaho
Code 363A00000X	Description Physician Assistant Physician Assistants & Advanced Practice Nursing Providers	License 12523 Minnesota

Susan Marie Schram

PECOS Enrollment

Profile Details

Contact Information

Practice Location

Mailing Location

Provider Taxonomies

Code

Description

License

Code

Description

License

Code

Description

License

Campbell, Joseph

Blanchet, Amanda

Blea, Kacey

Cole-Riccardi, Michelle Denise

Box, Nicholas J

Joly, Celeste

Baggs, Jacqueline

Conlin, Cheryl Ann

Johnson, Connor

Giles, Thomas Ryan