NPIMap

Individual provider Active NPI

Jeffrey T Seabourn, M.D.

  • Diagnostic Radiology Physician
  • Boise, ID
National Provider Identifier
1013964295
Registry record updated Oct 13, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
M6973 Issued in ID
Practice address
1055 N Curtis Rd
Boise, ID 83706-1309
Phone
(208) 367-2161
NPI assigned
May 31, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 13, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X M6973 ID Primary

Addresses

Primary practice location

1055 N Curtis Rd
Boise, ID 83706-1309

Mailing address

PO Box 9649
Boise, ID 83707-4649
Phone (208) 472-8100

Other identifiers 1

IdentifierTypeStateIssuer
003920700MedicaidID

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ID, OR2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20050808001282 ID Practitioner - Diagnostic Radiology 8022913524 Reassigns benefits to 2 organizations
I20110419000142 OR Practitioner - Diagnostic Radiology 8022913524 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
University of Nevada School of Medicine, 1990
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Gem State Radiology LLPGroup PAC ID 9335044833, 60 clinicians

Practice addresses (Care Compare)

1055 N Curtis Rd
Boise, ID 83706-1309
Phone (208) 367-2161

2559 S Honeycomb Way
Boise, ID 83716-5807
Phone (208) 954-8070

2929 E Magic View Dr
Meridian, ID 83642-3560
Phone (208) 367-8222

3325 Pocahontas Rd
Baker City, OR 97814-1464
Phone (541) 523-8137

4400 E Flamingo Ave
Nampa, ID 83687-9203
Phone (208) 288-4620

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as group
Quality
100
Improvement activities
40

Merit-based Incentive Payment System (MIPS)

Final score
85.82 of 100Reported as group
Quality
100
Improvement activities
40
Cost
52.72

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
M6973IDMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Gem State Radiology LLP Diagnostic Radiology CurrentSince Nov 4, 1996 Accepting new patients
Intermountain Medical Imaging LLC Diagnostic Radiology CurrentSince Aug 18, 2008 Accepting new patients
Gooding County Hospital District Past Accepting new patients

Locations

927 W Myrtle St
Boise, ID 83702
Phone (208) 367-7510

6200 W Emerald St
Boise, ID 83704
Phone (208) 367-3336

1055 N Curtis Rd
Boise, ID 83706
Phone (208) 367-2152

877 W Main St
Ste 603
Boise, ID 83702
Phone (208) 367-2161

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

323 E Riverside Dr
Ste 108
Eagle, ID 83616
Phone (208) 367-5700

875 S Vanguard Way
Ste 100
Meridian, ID 83642
Phone (208) 954-8100

2929 E Magic View Dr
Meridian, ID 83642
Phone (208) 367-8222

4424 E Flamingo Ave
#230
Nampa, ID 83687

4300 E Flamingo Ave
Nampa, ID 83687
Phone (208) 205-1000

3325 Pocahontas Rd
Baker City, OR 97814
Phone (541) 523-1797

351 SW 9th St
Ontario, OR 97914
Phone (541) 881-7000

Interoperability endpoints

  • Direct secure messaging: jseabourn1564127@direct.trinity-health.org

Organizations & group practices 4

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.

Hospital & facility affiliations 7

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": "1149033600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1318464000000",
    "number": "1013964295",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 9649",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837074649",
            "telephone_number": "208-472-8100",
            "fax_number": "208-472-8172"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1055 N CURTIS RD",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837061309",
            "telephone_number": "208-367-2161"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SEABOURN",
        "first_name": "JEFFREY",
        "middle_name": "T",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-31",
        "last_updated": "2011-10-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "ID",
            "license": "M6973",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "003920700",
            "state": "ID"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Boise, ID

Sources for this page

Verify at the official NPI Registry.