Mr Bradley James Heninger, PA-C - Medicare Physician Assistant in Fruitland, ID

Mr Bradley James Heninger, PA-C is a medicare enrolled "Physician Assistant - Medical" in Fruitland, Idaho. He graduated from nursing school in 2011 and has 13 years of diverse experience with area of expertise as Physician Assistant. He is a member of the group practice St Lukes Clinic-treasure Valley Llc and his current practice location is 910 Nw 16th Street, Ste 205, Fruitland, Idaho. You can reach out to his office (for appointments etc.) via phone at (208) 452-3111.

Mr Bradley James Heninger is licensed to practice in Idaho (license number PA-1026) and he also participates in the medicare program. He accepts medicare assignments (which means he accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance) and his NPI Number is 1205103389.

Contact Information

Mr Bradley James Heninger, PA-C
910 Nw 16th Street, Ste 205,
Fruitland, ID 83619
(208) 452-3111
(208) 452-3666



Provider's Profile

Full NameMr Bradley James Heninger
GenderMale
SpecialityPhysician Assistant
Experience13 Years
Location910 Nw 16th Street, Fruitland, Idaho
Accepts Medicare AssignmentsYes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance.
  Medical Education and Training:
  • Mr Bradley James Heninger graduated from nursing school in 2011
  NPI Data:
  • NPI Number: 1205103389
  • Provider Enumeration Date: 11/17/2011
  • Last Update Date: 02/17/2016
  Medicare PECOS Information:
  • PECOS PAC ID: 0547428013
  • Enrollment ID: I20140619002277

Medical Identifiers

Medical identifiers for Mr Bradley James Heninger such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1205103389NPI-NPPES

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
363AM0700XPhysician Assistant - Medical (Oregon)Secondary
363AM0700XPhysician Assistant - Medical PA-1026 (Idaho)Primary

Medical Facilities Affiliation

Facility NameLocationFacility Type
St Luke's Regional Medical CenterBoise, IDHospital

Group Practice Association

Group Practice NameGroup PECOS PAC IDNo. of Members
St Lukes Clinic-treasure Valley Llc4981878402968

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Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Mr Bradley James Heninger is enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing AddressPractice Location Address
Mr Bradley James Heninger, PA-C
3340 E Goldstone Way,
Meridian, ID 83642-1026

Ph: (208) 452-3111
Mr Bradley James Heninger, PA-C
910 Nw 16th Street, Ste 205,
Fruitland, ID 83619

Ph: (208) 452-3111

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Physician Assistant Nurses in Fruitland, ID

Tea Hasanovic, PA-C
Physician Assistant
Medicare: Accepting Medicare Assignments
Practice Location: 2101 N Whitley Dr, Fruitland, ID 83619
Phone: 208-452-5999    
George J Roth, PA-C
Physician Assistant
Medicare: Not Enrolled in Medicare
Practice Location: 1210 Nw 16th St, Fruitland, ID 83619
Phone: 208-452-8600    Fax: 208-452-8601
Charles Edward Brioschi Jr., PA
Physician Assistant
Medicare: Medicare Enrolled
Practice Location: 910 Nw 16th Street, Ste 205, Fruitland, ID 83619
Phone: 208-452-3111    Fax: 208-452-3666
Jaclyn R Hope,
Physician Assistant
Medicare: Accepting Medicare Assignments
Practice Location: 1210 Nw 16th St, Fruitland, ID 83619
Phone: 208-452-8600    
Thad W Wilkey, PA
Physician Assistant
Medicare: Accepting Medicare Assignments
Practice Location: 2101 N Whitley Dr, Fruitland, ID 83619
Phone: 208-452-5999    Fax: 208-452-4499
Mrs. Crysta Kimes, PA
Physician Assistant
Medicare: Accepting Medicare Assignments
Practice Location: 910 Nw 16th St Ste 101, Fruitland, ID 83619
Phone: 208-452-8000    
Victor M Ishida, P.A.
Physician Assistant
Medicare: Medicare Enrolled
Practice Location: 910 Nw 16th St Ste 101, Fruitland, ID 83619
Phone: 208-452-8050    Fax: 208-452-8055

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