Mr Jacob Wayne Moss, MD, JD is a medicare enrolled "General Practice" physician in Saint Anthony, Idaho. He went to Southern Illinois University School Of Medicine and graduated in 2013 and has 12 years of diverse experience with area of expertise as General Practice. He is a member of the group practice Teton Valley Health Care Inc and his current practice location is
335 E Main St Ste 1, Saint Anthony, Idaho. You can reach out to his office (for appointments etc.) via phone at
(208) 356-4900.
Mr Jacob Wayne Moss is licensed to practice in Idaho (license number M-14547) 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 1205179751.
Physician's Profile
| Full Name | Mr Jacob Wayne Moss |
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| Gender | Male |
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| Speciality | General Practice |
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| Experience | 12 Years |
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| Location | 335 E Main St Ste 1, Saint Anthony, Idaho |
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| Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
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Medical Education and Training:
- Mr Jacob Wayne Moss attended and graduated from Southern Illinois University School Of Medicine in 2013
NPI Data:
- NPI Number: 1205179751
- Provider Enumeration Date: 04/03/2013
- Last Update Date: 10/15/2025
Medicare PECOS Information:
- PECOS PAC ID: 0042454159
- Enrollment ID: I20191231002364
Medical Identifiers
Medical identifiers for Mr Jacob Wayne Moss such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
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| 1205179751 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 208D00000X | General Practice | M-14547 (Idaho) | Primary |
| 208D00000X | General Practice | TM190 (Georgia) | Secondary |
Medical Facilities Affiliation
Group Practice Association
| Group Practice Name | Group PECOS PAC ID | No. of Members |
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| Teton Valley Health Care Inc | 3870744956 | 31 |
Medicare Reassignments
Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Mr Jacob Wayne Moss allows following entities to bill medicare on his behalf.
| Entity Name | Teton Valley Health Care Inc |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1013264183
PECOS PAC ID: 3870744956
Enrollment ID: O20121128000587 |
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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 Jacob Wayne Moss 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 Address | Practice Location Address |
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Mr Jacob Wayne Moss, MD, JD
Po Box 18,
Saint Anthony, ID 83445-0018
Ph: (208) 356-4900 | Mr Jacob Wayne Moss, MD, JD
335 E Main St Ste 1,
Saint Anthony, ID 83445-1546
Ph: (208) 356-4900 |
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