Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Joseph E Molloy

Individual provider Physician Assistant · NPI 1194249110

Joseph E Molloy is a Physician Assistant in Fruitland, Idaho. Qualified in 2018, 8 years ago. Practices as a sole proprietor, works from 2 locations and accepts Medicare assignment. Licensed in California and Idaho.

Years since qualifying
8
Licensed in
CA, ID
In the registry since
2017
Specialties on file
2
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Practice location Address checks out

1210 NW 16th St
Fruitland, ID 83619-2202
Phone: (208) 452-8700
Fax: (208) 452-8701
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 8700 Beverly Blvd, West Hollywood, CA 90048-1804 — (310) 423-5000

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence 1671360 (ID)
Physician Assistant Taxonomy 363A00000X · Licence PA57157 (CA)

Record details

NPI number1194249110
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorYes
NPI enumeratedAugust 1, 2017
Last updated in NPPESAugust 27, 2025
Certification dateAugust 27, 2025

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2018 (8 years in practice)
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations2 on file with Medicare

Other providers in Fruitland