Doctor profile · Federal record

Dr. Lacy Wagner, PA

Physician Assistant · Physician Assistant · Boise, ID

  • NPI 1508537507
  • Accepts Medicare
  • 5 yrs in practice
  • Female
  • Group practice
  • No sanctions

Practice & contact

Operates at 2 locations .

NPPES Updated May 11, 2026
Primary practice
6051 W Emerald St
Boise, ID 837048969
(208) 302-5150
fax (208) 302-5155
Additional location
1856 E Fireside Dr
Meridian, ID 836421118
(805) 748-9554
Mailing address
3340 E Goldstone Dr
Meridian, ID 836421026

Credentials & registration

NPPES · NUCC
NPI registered
September 2021 — 5 yrs on file
Profile last updated
January 26, 2022
Year of graduation
2021 — 5 yrs since
Specialty taxonomy
363A00000X — NUCC code
State license (1)
Idaho #PA-2169

Federal sanctions & exclusions

OIG LEIE Updated May 11, 2026

No sanctions, exclusions or revocations on file

Checked against OIG LEIE on NPI 1508537507. Last verified May 11, 2026.

Medicare procedures · 2023

Top services delivered

CMS Provider Utilization
Total services
48
Distinct HCPCS
2
Medicare allowed
$2,697
HCPCS Description Services Patients Avg allowed
99213 Established patient office or other outpatient visit, 20-29 minutes 36 36 $53
99203 New patient office or other outpatient visit, 30-44 minutes 12 12 $65

In context: peer comparison

Among 112 peers in Boise Physician Assistant, average services per provider: 73. This provider delivers 0.7× the peer median.

Open Payments

Industry payments received

CMS Open Payments
All-time total
$17
Transactions
1
Manufacturers
1
Payer (manufacturer) Industry Txns Amount
Novo Nordisk INC 1 $17.49

By nature of payment

Food and Beverage
$17

Frequently asked questions

Auto-generated from federal data
What is Dr. Lacy Wagner's medical specialty?
Dr. Lacy Wagner practices Physician Assistant in Boise, ID.
Where does Dr. Lacy Wagner practice?
Dr. Lacy Wagner practices at 6051 W Emerald St, Boise, ID 837048969. Office phone: 2083025150.
What is Dr. Lacy Wagner's NPI?
Dr. Lacy Wagner's National Provider Identifier (NPI) is 1508537507, issued by NPPES.
Does Dr. Lacy Wagner accept Medicare assignment?
Yes. Dr. Lacy Wagner accepts Medicare assignment, meaning Medicare-allowed amounts are accepted as full payment for covered services.
What procedures does Dr. Lacy Wagner commonly perform?
Top Medicare-reported procedures in 2023: Established patient office or other outpatient visit (HCPCS 99213); New patient office or other outpatient visit (HCPCS 99203). Source: CMS Medicare Physician & Other Practitioners file.