P Praxis·MD
● Active Type 1 · Individual

MR. Michael Kenneth Wucinich, PA-C

Physician Assistant·Twin Falls, ID· NPI 1407223274 · Enumerated 2015 · 10 years on NPI
Wucinich is 1 of 16 physician assistant providers in Twin Falls and 1 of 387 in Idaho.
NPI age
10 years
Enumerated 2015-08-28
Primary specialty
Physician Assistant
Licensed in
ID
1 state
Status
Active
No deactivations on record
Last NPPES update
2015-11-19
Source: monthly bulk 2026-05
Sole proprietor
No
May be part of a larger org

How this provider compares

Across 387 active physician assistant providers in Idaho.

NPI age
10 years
↓ 5 yr below median (15 yr)
State licenses
1 state
16% of peers hold multiple states
Subspecialties
0
30% of peers hold subspecialties

NPI lifetime · 2015 → 2026

2015-08Enumerated in NPPES
2015 2026

Where they practice

Practice location
775 Pole Line Rd W Ste 302
Twin Falls, ID 833015823
📞 2088148725
Mailing address
3724 E 3770 N
Kimberly, ID 833415524
📞 2084208188

Specialties

  • Physician Assistant Primary
    Definition to come...
    ID license #1274 taxonomy 363AM0700X

Practice context

Part of a multi-provider practice. 3 other active providers share this practice address in NPPES.

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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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