DEREK SCOTT AHLSTROM (PA) – Physician Assistant, NPI 1174096606
Physician Assistant
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
Provider Addresses for DEREK SCOTT AHLSTROM (PA)
9292 W Barnes Dr
Boise, ID 837091554
Phone: (208) 795-3515
Type: Location
6600 W Emerald St
Boise, ID 837048738
Phone: (208) 609-9020
Type: Location
1650 S TOPAZ WAY
MERIDIAN, ID 836424474
Phone: (208) 605-7070
Type: Mailing
Parkcentre Way, Nampa, Canyon County, Idaho, 83678, United States
NAMPA, ID 836511794
Phone: (208) 229-6050
Fax: (855) 212-5682
Type: Location
2335 E State Ave
Meridian, ID 836428808
Phone: (208) 672-1801
Type: Location
7416 212th St SW
Edmonds, WA 980267602
Phone: (425) 245-5800
Type: Location
924 S Pines Rd Ste 101
Spokane Valley, WA 992065423
Phone: (509) 299-8160
Type: Location
2111 N Northgate Way Ste 101
Seattle, WA 981339018
Phone: (206) 309-3740
Type: Location
2111 N Northgate Way Ste 100
Seattle, WA 981339018
Phone: (425) 502-9945
Type: Location
847 Parkcentre Way Ste 7
Nampa, ID 836511794
Phone: (208) 229-6050
Type: Location
7941 W RIFLEMAN ST
BOISE, ID 837049001
Phone: (208) 895-7950
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 8 Open Payments records for all available years, with a total value of $429.
Total Amount is formed as General ($429) + Research ($0) + Ownership ($0) = $429.
Last reported payment date: 2024-10-17 • Largest payer in this snapshot: Alkermes, Inc. ($172).
Total Amount
$429
General + Research + Ownership
Payments
8
Total payment records
General Amount
$429
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-10-17
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| Alkermes, Inc. | $172 |
| Janssen Pharmaceuticals, Inc | $127 |
| Neurocrine BioSciences Inc. | $102 |
| Actelion Pharmaceuticals US, Inc. | $27 |
Medicare Enrollment & Revalidation
Source: CMS public data · Not endorsed by CMS ·
Educational use only—not medical, billing, or legal advice.
PECOS enrollment status
Participating (accepts Medicare assignment)
Enrollment effective: 2019-04-09
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.
Enrollment records
1
Earliest due date
Not assigned (TBD)
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20190409001185 | I | Physician Assistant | ID | TBD |
What to do next
- No action required while the due date shows TBD.
- Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
- Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.
Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS
Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
Educational use only—not medical, billing, or legal advice.
No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 83709)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Clinical Social Worker | OR | |
| Mental Health Counselor | OR | |
| Clinical Social Worker | OR | |
| Undefined Non Physician Type (Specify) | OR | |
| Clinical Social Worker | OR | |
| - | ID | |
| - | ID | |
| - | OH | |
| Clinical Social Worker | OR | |
| Undefined Non Physician Type (Specify) | OR |
Reviews
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