| Jason M Ellison, MD | |
|
1072 N Liberty St, Ste 200, Boise, ID 83704 | |
| (208) 302-4600 | |
| (208) 302-4655 |
| Full Name | Jason M Ellison |
|---|---|
| Gender | Male |
| Speciality | Pediatric Medicine |
| Experience | 24 Years |
| Location | 1072 N Liberty St, Boise, Idaho |
| Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1740231455 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 208000000X | Pediatrics | M10380 (Idaho) | Secondary |
| 2080P0206X | Pediatrics - Pediatric Gastroenterology | M-10380 (Idaho) | Primary |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Saint Alphonsus Regional Medical Center Inc | 3476462359 | 665 |
| Entity Name | Saint Alphonsus Regional Medical Center Inc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1649357716 PECOS PAC ID: 3476462359 Enrollment ID: O20040204001036 |
| Mailing Address | Practice Location Address |
|---|---|
| Jason M Ellison, MD 3340 E Goldstone Way, Meridian, ID 83642 Ph: (208) 302-4600 | Jason M Ellison, MD 1072 N Liberty St, Ste 200, Boise, ID 83704 Ph: (208) 302-4600 |
Dr. Nathan D Meeker, M.D. Pediatrics Medicare: Accepting Medicare Assignments Practice Location: 100 E Idaho St, Boise, ID 83712 Phone: 208-381-2782 Fax: 208-381-3172 | |
Nicolas A Camilo, MD Pediatrics Medicare: May Accept Medicare Assignments Practice Location: 100 E Idaho St., Boise, ID 83712 Phone: 208-381-2782 Fax: 208-381-3172 | |
Heather Carew, M.D. Pediatrics Medicare: Medicare Enrolled Practice Location: 190 E Bannock St, Boise, ID 83712 Phone: 208-381-2645 | |
Dr. Frederick K Emge, MD Pediatrics Medicare: Medicare Enrolled Practice Location: 100 E Idaho St, Suite 200, Boise, ID 83712 Phone: 208-381-7384 Fax: 208-381-7387 | |
Annis Wakelee Vargas, M.D. Pediatrics Medicare: Medicare Enrolled Practice Location: 1072 N Liberty Street, Ste 203, Boise, ID 83701 Phone: 208-302-5800 Fax: 208-302-5855 | |
Mrs. Lisa S Labor, MD Pediatrics Medicare: Medicare Enrolled Practice Location: 8610 W Overland Rd, Boise, ID 83709 Phone: 208-954-8711 Fax: 208-375-2217 | |
Mikelle E Mikesell, DO Pediatrics Medicare: Medicare Enrolled Practice Location: 8610 W Overland Rd, Boise, ID 83709 Phone: 208-954-8711 |