P Praxis·MD
● Active Type 1 · Individual

Roger David Cushman, P.A.

Physician Assistant·Pocatello, ID· NPI 1578742615 · Enumerated 2007 · 18 years on NPI
Cushman is 1 of 33 physician assistant providers in Pocatello and 1 of 387 in Idaho.
NPI age
18 years
Enumerated 2007-10-25
Primary specialty
Physician Assistant
Licensed in
ID
1 state
Status
Active
No deactivations on record
Last NPPES update
2007-10-25
Source: monthly bulk 2026-05
Sole proprietor
Yes
Solo practice on file

How this provider compares

Across 387 active physician assistant providers in Idaho.

NPI age
18 years
↑ 3 yr above median (15 yr)
State licenses
1 state
16% of peers hold multiple states
Subspecialties
0
30% of peers hold subspecialties

NPI lifetime · 2007 → 2026

2007-10Enumerated in NPPES
2007 2026

Where they practice

Practice location
2302 E. Terry Street
Pocatello, ID 83201
📞 2082355910
Mailing address
Po Box 335
Pocatello, ID 832040335
📞 2082355910

Specialties

  • Physician Assistant Primary
    Definition to come...
    ID license #GPA-034 taxonomy 363AM0700X

Practice context

Part of a multi-provider practice. 2 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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