NPI age
18 years
Enumerated 2008-01-23
● Active
Type 1 · Individual
MR. Tracy D. Mickelsen, CSFA
Mickelsen is 1 of 14 physician assistant providers in Meridian and 1 of 97 in Idaho.
Primary specialty
Physician Assistant
Licensed in
ID
1 state
Status
Active
No deactivations on record
Last NPPES update
2017-12-07
Source: monthly bulk 2026-05
Sole proprietor
Yes
Solo practice on file
How this provider compares
Across 97 active physician assistant providers in Idaho.
NPI age
18 years
↑ 5 yr above median (13 yr)
State licenses
1 state
23% of peers hold multiple states
Subspecialties
0
56% of peers hold subspecialties
NPI lifetime · 2008 → 2026
2008-01Enumerated in NPPES
2008
2026
Where they practice
Practice location
3015 E Magic View Dr
Meridian, ID 836423743
Mailing address
3015 E Magic View Dr
Meridian, ID 836423743
Specialties
-
Physician Assistant PrimaryDefinition to come...
Practice context
Part of a multi-provider practice. 6 other active providers share this practice address in NPPES.
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Request a quote →How to verify this provider
- Confirm the NPI on NPPES.The CMS registry is the system of record. Open NPPES →
- Check the state license is currently active.State licensing boards publish current status; NPPES does not.
- Confirm payer enrollment if billing.NPI presence does not guarantee active enrollment with Medicare, Medicaid, or commercial payers.