P Praxis·MD
● Active Type 1 · Individual

Carl Ryan Andrus, P.A.

Physician Assistant·Boise, ID· NPI 1215949532 · Enumerated 2006 · 19 years on NPI
Andrus is 1 of 363 physician assistant providers in Boise and 1 of 1263 in Idaho.
NPI age
19 years
Enumerated 2006-08-13
Primary specialty
Physician Assistant
Licensed in
ID
1 state
Status
Active
No deactivations on record
Last NPPES update
2007-07-08
Source: monthly bulk 2026-05
Sole proprietor
No
May be part of a larger org

How this provider compares

Across 1263 active physician assistant providers in Idaho.

NPI age
19 years
↑ 10 yr above median (9 yr)
State licenses
1 state
19% of peers hold multiple states
Subspecialties
0
35% of peers hold subspecialties

NPI lifetime · 2006 → 2026

2006-08Enumerated in NPPES
2006 2026

Where they practice

Practice location
4902 W State St
Boise, ID 837033326
📞 2088533100fax 2088533120
Mailing address
4902 W State St
Boise, ID 837033326
📞 2088533100fax 2088533120

Specialties

  • Physician Assistant Primary
    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...
    ID license #PA-508 taxonomy 363A00000X

Identifiers

TypeValueNotes
01 (ID) 000010157032 BLUE CROSS
05 (ID) 807520000
01 (ID) PAD25 BLUE CROSS
01 (ID) 000010157033 BLUE SHIELD
01 (ID) PAD26 BLUE CROSS

Practice context

Part of a multi-provider practice. 4 other active providers share this practice address in NPPES.

Recently enumerated nearby: 3 new physician assistant providers have been added in Boise in the last 180 days. See all →
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How to verify this provider

  1. Confirm the NPI on NPPES.The CMS registry is the system of record. Open NPPES →
  2. Check the state license is currently active.State licensing boards publish current status; NPPES does not.
  3. Confirm payer enrollment if billing.NPI presence does not guarantee active enrollment with Medicare, Medicaid, or commercial payers.

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