Individual provider Active NPI

Jason A Syrek, D.C.

  • Chiropractor
  • Boise, ID
National Provider Identifier
1154418929
Registry record updated Mar 10, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
CHIA-2020 Issued in ID
Practice address
5983 W State St Ste B
Boise, ID 83703-3055
Phone
(208) 408-3544
NPI assigned
Oct 5, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 10, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X CH00033952 WA
Chiropractor 111N00000X CHIA-2020 ID Primary

Addresses

Primary practice location

5983 W State St Ste B
Boise, ID 83703-3055

Mailing address

5757 Capitol Blvd SE
Suite a
Tumwater, WA 98501
Phone (360) 357-5222

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ID

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210429001160 ID Practitioner - Chiropractic 6103717376 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Western States College of Chiropractic, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

5983 W State St
Suite B
Boise, ID 83703-3055
Phone (208) 408-3544

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
CHIA-2020IDMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Idaho Chiropractic Company LLC Chiropractor CurrentSince Aug 14, 2020 Accepting new patients

Locations

5983 W State St
Ste B
Boise, ID 83703
Phone (208) 408-3544

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1160006400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1615334400000",
    "number": "1154418929",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5757 CAPITOL BLVD SE",
            "address_2": "SUITE A",
            "city": "TUMWATER",
            "state": "WA",
            "postal_code": "98501",
            "telephone_number": "360-357-5222"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5983 W STATE ST STE B",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837033055",
            "telephone_number": "208-408-3544"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SYREK",
        "first_name": "JASON",
        "middle_name": "A",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-05",
        "last_updated": "2021-03-10",
        "certification_date": "2021-03-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "WA",
            "license": "CH00033952",
            "primary": false
        },
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "ID",
            "license": "CHIA-2020",
            "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 10, 2021; 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.