Jessica Jerdin, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

3081018 Issued in ID

Practice address

6165 W Emerald St
Boise, ID 83704-8613

Phone

(208) 302-3900

Fax

(208) 302-3955

NPI assigned

Mar 9, 2023

Reactivated

Jul 9, 2024

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in OR, ID2 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 2

Specialty

Physician Assistant

Education

Other, 2025

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Silverton HealthGroup PAC ID 8921901877, 147 clinicians

Summit Orthopaedics, LLPGroup PAC ID 4789725607, 18 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Legacy Emanuel Medical Center Hospital, Portland, OR, CCN 380007
• Legacy Silverton Medical Center Hospital, Silverton, OR, CCN 380029

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Silverton Health

  • General Acute Care Hospital
  • Silverton, OR
  • NPI 1669424354
  Medicare reassignment Care Compare group
• Summit Orthopaedics, LLP

  • Orthopaedic Surgery Physician
  • Lake Oswego, OR
  • NPI 1427200021
  Medicare reassignment Care Compare group
• Go to Ortho LLC

  • Orthopedic Physical Therapist
  • Lake Oswego, OR
  • NPI 1083206155
  Medicare reassignment
• TS Billings, LLC

  • Trauma Surgery Physician
  • Portland, OR
  • NPI 1497776488
  NPD (past)
• TS Pos Billings L L C

  • Orthopaedic Trauma Physician
  • Portland, OR
  • NPI 1497082366
  NPD (past)
• TS Radiology Billings, LLC

  • Diagnostic Radiology Physician
  • Portland, OR
  • NPI 1669413514
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Legacy Emanuel Hospital & Health Center

  • General Acute Care Hospital
  • Portland, OR
  • NPI 1003367491
  Care Compare affiliation
• Legacy Emanuel Hospital & Health Center

  • Clinical Medical Laboratory
  • Portland, OR
  • NPI 1295756898

  Hospital

  Care Compare affiliation
• Legacy Emanuel Hospital & Health Center

  • Clinic/Center
  • Portland, OR
  • NPI 1700809027

  Hospital

  Care Compare affiliation
• Legacy Emanuel Hospital & Health Center

  • General Acute Care Hospital
  • Portland, OR
  • NPI 1831112358
  Care Compare affiliation
• Silverton Health

  • General Acute Care Hospital
  • Silverton, OR
  • NPI 1669424354
  Care Compare affiliation

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1678320000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1780617600000",
    "number": "1003516758",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 190930",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837190930",
            "telephone_number": "208-367-5170",
            "fax_number": "208-367-5180"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6165 W EMERALD ST",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837048613",
            "telephone_number": "208-302-3900",
            "fax_number": "208-302-3955"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "452 Welch St",
            "address_purpose": "LOCATION",
            "city": "Silverton",
            "state": "OR",
            "postal_code": "973811934",
            "country_code": "US",
            "telephone_number": "503-874-2454",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2695 SW Cedar Hills Blvd Ste G140",
            "address_purpose": "LOCATION",
            "city": "Beaverton",
            "state": "OR",
            "postal_code": "970051392",
            "country_code": "US",
            "telephone_number": "503-850-9950",
            "fax_number": "866-252-2247",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4103 Mercantile Dr",
            "address_purpose": "LOCATION",
            "city": "Lake Oswego",
            "state": "OR",
            "postal_code": "970352556",
            "country_code": "US",
            "telephone_number": "503-850-9940",
            "fax_number": "877-533-6717",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JERDIN",
        "first_name": "JESSICA",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-03-09",
        "last_updated": "2026-06-05",
        "certification_date": "2026-06-05",
        "deactivation_date": "2023-08-01",
        "reactivation_date": "2024-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "OR",
            "license": "PA224310",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "ID",
            "license": "3081018",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "500855147",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Physician Assistant in Boise, ID
• Providers in Boise, ID by specialty
• Physician Assistant in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 5, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.