NPIMap

Individual provider Active NPI

Jennifer S Anderson, MD

  • Internal Medicine Physician
  • Boise, ID
National Provider Identifier
1093825903
Registry record updated Mar 11, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
M-12001 Issued in ID
Practice address
300 E Jefferson St Ste 101
Boise, ID 83712-6221
Phone
(208) 322-1680
Fax
(208) 322-1695
NPI assigned
Aug 30, 2006
Last updated
Mar 11, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 11, 2024

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

Specialties & licenses 6

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X MD60022458 WA
Internal Medicine Physician 207R00000X ML20008610 WA
Internal Medicine Physician 207R00000X 2009-02126 NC
Internal Medicine Physician 207R00000X M-12001 ID Primary
Cardiovascular Disease Physician 207RC0000X M-12001 ID
Cardiovascular Disease Physician 207RC0000X MD161181 OR

Addresses

Primary practice location

300 E Jefferson St Ste 101
Boise, ID 83712-6221

Mailing address

190 E Bannock St
Boise, ID 83712-6241

Other names 1

  • Jennifer Marie Schultz Former name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20130827000458 ID Practitioner - Cardiovascular Disease (Cardiology)Practitioner - Internal Medicine 7214063379 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Cardiovascular Disease (Cardiology)Also: Internal Medicine
Education
Other, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
St Lukes Clinic-Treasure Valley LLCGroup PAC ID 4981878402, 1,155 clinicians

Practice addresses (Care Compare)

100 E Bannock St
Boise, ID 83712-6241
Phone (208) 381-2983

190 E Bannock St
Boise, ID 83712-6241
Phone (208) 381-9384

300 E Jefferson St
Boise, ID 83712-6221
Phone (208) 322-1680

3301 N Sawgrass Way
Boise, ID 83704-4493
Phone (208) 375-0862

3525 E Louise Dr
Meridian, ID 83642-6303

520 S Eagle Rd
Meridian, ID 83642-6351

608 W Hays St
Boise, ID 83702-5511
Phone (208) 381-5970

610 W Hays St
Boise, ID 83702-5511
Phone (208) 381-5970

9580 W St Lukes Dr
Nampa, ID 83687-7912
Phone (208) 505-2711

9850 St Lukes Dr
Nampa, ID 83687-7912

9850 W St Luke's Dr
Nampa, ID 83687-7912

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
87.3 of 100Reported as group
Quality
81.29
Promoting interoperability
100
Improvement activities
40
Cost
76.37

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
M-12001IDMDInternal Medicine Physician
2009-02126NCMDInternal Medicine Physician
MD60022458WAMDInternal Medicine Physician
ML20008610WAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
St Lukes Clinic-Treasure Valley LLC Internal Medicine CurrentSince Mar 11, 2024 Accepting new patients
St Lukes Clinic-Treasure Valley LLC Internal Medicine CurrentSince Mar 11, 2024 Accepting new patients
Southern Idaho Health Partners LLC CurrentSince Oct 1, 2022 Accepting new patients
St Lukes Regional Medical Center Past Accepting new patients

Locations

190 E Bannock St
Boise, ID 83712
Phone (208) 381-2378

300 E Jefferson St
Ste 101
Boise, ID 83712
Phone (208) 336-4141

610 W Hays St
Boise, ID 83702
Phone (208) 345-3530

875 S Vanguard Way
Ste 200
Meridian, ID 83642
Phone (208) 298-9949

215 E Hawaii Ave
Nampa, ID 83686
Phone (208) 463-3234

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

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/11411/brand/1/csg/1/fhir/r4

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 11

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": "1156896000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1710115200000",
    "number": "1093825903",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "190 E BANNOCK ST",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837126241"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 E JEFFERSON ST STE 101",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837126221",
            "telephone_number": "208-322-1680",
            "fax_number": "208-322-1695"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANDERSON",
        "first_name": "JENNIFER",
        "middle_name": "S",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-30",
        "last_updated": "2024-03-11",
        "certification_date": "2024-03-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "WA",
            "license": "MD60022458",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "WA",
            "license": "ML20008610",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NC",
            "license": "2009-02126",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "ID",
            "license": "M-12001",
            "primary": true
        },
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "ID",
            "license": "M-12001",
            "primary": false
        },
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "OR",
            "license": "MD161181",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JENNIFER",
            "last_name": "SCHULTZ",
            "middle_name": "MARIE",
            "credential": "MD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Boise, ID

Sources for this page

Verify at the official NPI Registry.