Tucker Jeppson, DO
Individual provider Active NPI Diagnostic Radiology Physician · Moscow, ID
NPI 1104455922 · NPPES record last updated Aug 18, 2025
Key facts
- NPI
- 1104455922
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Diagnostic Radiology Physician 2085R0202X
- License
- 9861270 (ID)
- Practice address
- 220 W 3Rd St
Moscow, ID 83843-2203 - Phone
- (208) 882-8369
- NPI assigned
- Apr 3, 2020
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 9
Hospital & facility affiliations 15
Medicare Care Compare profile
- Specialty
- Diagnostic Radiology
- Education
- Pacific NW Un of HS, Col of Osteopathic Medicine, 2020
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Palouse Imaging Consultants, PLLC
Clearwater Valley Hospital and Clinics
St Marys Hospital Inc
Practice addresses (Care Compare)
1200 W Fairview St
Colfax, WA 99111-9552
Phone (509) 397-3435
301 Cedar St
Orofino, ID 83544-9029
Phone (208) 476-5777
700 S Main St
Moscow, ID 83843-3056
Phone (208) 882-4511
701 Lewiston St
Cottonwood, ID 83522-9750
Phone (208) 962-3251
Hospital & facility affiliations
- Gritman Medical Center
- Whitman Hospital and Medical Center
- St Mary'S Hospital
- Clearwater Valley Hospital & Clinics
- Pullman Regional Hospital
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (2 enrollments) in WA, ID
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20250804001238 | WA | Practitioner - Diagnostic Radiology | 0648788455 | Reassigns benefits to 1 organization |
| I20250805001658 | ID | Practitioner - Diagnostic Radiology | 0648788455 | Reassigns benefits to 5 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Osteopathy
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Palouse Imaging Consultants, PLLC | Diagnostic Radiology | Current |
Accepting new patients |
| St. Mary'S Hospital Inc | Current |
Accepting new patients | |
| St. Mary'S Hospital Inc | Current |
Accepting new patients | |
| Clearwater Valley Hospital & Clinics Inc. | Current |
Accepting new patients | |
| Clearwater Valley Hospital & Clinics Inc. | Current |
Accepting new patients | |
| Clearwater Valley Hospital & Clinics Inc. | Current |
Accepting new patients |
Locations
701 Lewiston St
Cottonwood, ID 83522
Phone (208) 962-3251
700 S Main St
Moscow, ID 83843
Phone (208) 746-7555
220 W 3rd St
Moscow, ID 83843
Phone (208) 882-8369
301 Cedar St
Orofino, ID 83544
Phone (208) 476-4555
1200 W Fairview St
Colfax, WA 99111
Phone (509) 397-3435
Interoperability endpoints
- tjeppson480301@direct.franciscanalliance.org
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Diagnostic Radiology Physician | 2085R0202X | 9861270 | ID | Yes |
Addresses
Primary practice location
220 W 3Rd St
Moscow, ID 83843-2203
Mailing address
PO Box 9583
Moscow, ID 83843-0177
Phone (208) 882-8369
Other practice location 1
701 Lewiston St
Cottonwood, ID 83522-9750
Phone (208) 962-3251
Other practice location 2
1200 W Fairview St
Colfax, WA 99111-9552
Phone (208) 882-8369
Other practice location 3
301 Cedar St
Orofino, ID 83544-9029
Phone (208) 882-8369
Other practice location 4
20201 Crawford Ave
Olympia Fields, IL 60461-1010
Phone (708) 747-4000
Other providers in Moscow, ID
- Patrick Joseph Jamsa
- Emily Jardine
- Joel Theodore Jaureguito
- Aubrie Jeansonne
- Tiarra Jeff
- John a Werner PLLC
- Benjamin Henning Johnson
- Carman A Johnson
- Dallisa Johnson
- Hunter Isaac Johnson
All providers in Moscow, ID · Diagnostic Radiology Physician in Idaho
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 18, 2025. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.