NPIMap

Individual provider Active NPI

Jordan B Wolff, CRNA

  • Certified Registered Nurse Anesthetist
  • Boise, ID
National Provider Identifier
1013158807
Registry record updated Mar 9, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
RNA749 Issued in ID
Practice address
111 W State St
Boise, ID 83702-6127
Phone
(208) 336-0895
Fax
(208) 338-1796
NPI assigned
Mar 9, 2009
Last updated
Mar 9, 2009By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 9, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X RNA749 ID Primary

Addresses

Primary practice location

111 W State St
Boise, ID 83702-6127

Mailing address

111 W State St
Boise, ID 83702-6127
Phone (208) 336-0895

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ID, PA2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20090514000103 ID Practitioner - Certified Registered Nurse Anesthetist (Crna) 2365591823 Reassigns benefits to 5 organizations
I20250922003359 PA Practitioner - Certified Registered Nurse Anesthetist (Crna) 2365591823 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Susquehanna Physician ServicesGroup PAC ID 2264336460, 611 clinicians
Anesthesiology Consultants of Treasure Valley PLLCGroup PAC ID 4981661196, 27 clinicians

Practice addresses (Care Compare)

700 High St
Williamsport, PA 17701-3100
Phone (570) 321-1279

8800 W Emerald St
Boise, ID 83704-8205
Phone (208) 373-5000

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Registered Nurse

State licenses

LicenseStateTypeSpecialty
RNA749IDMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Walter Knox Memorial Hospital CurrentSince Jul 30, 2018 Accepting new patients
Susquehanna Physician Services CurrentSince Jul 14, 2025 Accepting new patients
Anesthesiology Consultants of Treasure Valley PLLC CurrentSince Apr 1, 2017 Accepting new patients
Anesthesia Consulting Partners Idaho, PC Nurse Anesthetist, Certified Registered CurrentSince Nov 13, 2023 Accepting new patients
Cardiac and Arrhythmia Center of Idaho PLLC CurrentSince Oct 18, 2022 Accepting new patients
Susquehanna Physician Services Nurse Anesthetist, Certified Registered CurrentSince Jul 14, 2025 Accepting new patients
Anesthesia Associates of Boise, P.a. PastSince Jun 17, 1997 Accepting new patients
Everest ASC Past Accepting new patients
Coeur D Alene Primary Care PLLC PastSince Jan 1, 2023 Accepting new patients

Locations

8800 W Emerald St
Boise, ID 83704
Phone (208) 373-5000

1717 Arlington Ave
Caldwell, ID 83605
Phone (208) 455-3719

1202 E Locust St
Emmett, ID 83617
Phone (208) 365-2338

2960 E St Lukes St
Ste 100
Meridian, ID 83642
Phone (208) 378-4264

1100 Grampian Blvd
#P
Williamsport, PA 17701
Phone (570) 326-8457

1201 Grampian Blvd
Williamsport, PA 17701
Phone (570) 326-8723

700 High St
Williamsport, PA 17701
Phone (570) 321-1000

Interoperability endpoints

  • FHIR API: https://fhir-myrecord.cerner.com/r4/eb237299-e2be-4fd4-aca6-5fa7adcd28c1/

Organizations & group practices 10

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

Hospital & facility affiliations 8

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

NPI Registry JSON

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

{
    "created_epoch": "1236556800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1236556800000",
    "number": "1013158807",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "111 W STATE ST",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837026127",
            "telephone_number": "208-336-0895",
            "fax_number": "208-338-1796"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 W STATE ST",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837026127",
            "telephone_number": "208-336-0895",
            "fax_number": "208-338-1796"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WOLFF",
        "first_name": "JORDAN",
        "middle_name": "B",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-03-09",
        "last_updated": "2009-03-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "ID",
            "license": "RNA749",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boise, ID

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 9, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.