NPIMap

Individual provider Active NPI

Jason Scott Ludwig, D.O.

  • Family Medicine Physician
  • Meridian, ID
National Provider Identifier
1144258534
Registry record updated Jan 20, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
O-253 Issued in ID
Practice address
4740 N Penngrove Way Ste 100
Meridian, ID 83646-7446
Phone
(208) 938-3663
Fax
(208) 938-3664
NPI assigned
Jun 28, 2006
Last updated
Jan 20, 2020By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 20, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X O-253 ID Primary

Addresses

Primary practice location

4740 N Penngrove Way Ste 100
Meridian, ID 83646-7446

Mailing address

4740 N Penngrove Way Ste 100
Meridian, ID 83646-7446
Phone (208) 938-3663

Other identifiers 1

IdentifierTypeStateIssuer
806067800MedicaidID

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
I20120124000927 ID Practitioner - Family PracticePractitioner - Osteopathic Manipulative Medicine 6901824572 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family PracticeAlso: Osteopathic Manipulative Medicine
Education
Des Moines University of Osteopathic Medicine and Health Sciences, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Pioneer Family Medicine PLLCGroup PAC ID 5193877850, 13 clinicians

Practice addresses (Care Compare)

4740 N Penngrove Way
Suite 100
Meridian, ID 83646-7446
Phone (208) 938-3663

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10
Skin biopsy1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
O-253IDMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Pioneer Family Medicine PLLC Family Medicine CurrentSince Sep 1, 2002 Accepting new patients
Treasure Valley Emergency Physicians Past Accepting new patients
Emerald Medical Investors, LLC Past Accepting new patients
Payette of Cascadia, LLC Past Accepting new patients
Caringedge Hospice of Casper LLC Family Medicine PastSince Mar 1, 2023 Accepting new patients
Boise Nursing and Rehab Center LLC Past Accepting new patients
Premier Emergency Physicians of Idaho Medical Group Past Accepting new patients

Locations

13150 W Persimmon Ln
Boise, ID 83713
Phone (208) 510-9890

4740 N Penngrove Way
Ste 100
Meridian, ID 83646
Phone (208) 938-3663

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/FBBGCA
  • FHIR API: https://fhir4.healow.com/fhir/r4/FBBGCA/Endpoint/FBBGCA

Ownership & related parties

All facility ownership & control disclosures 3

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Life Care Center of Treasure ValleyBoise, ID, CCN 135123 Skilled nursing facility Operational/Managerial Control
Adp of the SNF		 Jan 1, 2019
Mar 14, 2025
Payette Healthcare of CascadiaPayette, ID, CCN 135015 Skilled nursing facility Operational/Managerial Control
Adp of the SNF		 Dec 21, 2023
Jul 15, 2025
Achs Hospice & Palliative Care, LLCEagle, ID, CCN 131571 Hospice Contracted Managing Employee
5% Or Greater Indirect Ownership Interest (7.5%)		 Mar 1, 2023
Oct 27, 2017

Owned or controlled facilities with NPI records 3

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Organizations & group practices 7

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 21

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

View all 21

NPI Registry JSON

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

{
    "created_epoch": "1151452800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1579478400000",
    "number": "1144258534",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4740 N PENNGROVE WAY STE 100",
            "city": "MERIDIAN",
            "state": "ID",
            "postal_code": "836467446",
            "telephone_number": "208-938-3663",
            "fax_number": "208-938-3664"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4740 N PENNGROVE WAY STE 100",
            "city": "MERIDIAN",
            "state": "ID",
            "postal_code": "836467446",
            "telephone_number": "208-938-3663",
            "fax_number": "208-938-3664"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LUDWIG",
        "first_name": "JASON",
        "middle_name": "SCOTT",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-28",
        "last_updated": "2020-01-20",
        "certification_date": "2020-01-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "ID",
            "license": "O-253",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "806067800",
            "state": "ID"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Meridian, ID

Sources for this page

Verify at the official NPI Registry.