NPIMap

Individual provider Active NPI

Jeremy Daniel Frix, PA

  • Physician Assistant
  • Meridian, ID
National Provider Identifier
1164450862
Registry record updated Feb 20, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA-552 Issued in ID
Practice address
1648 NW 1St Street
Meridian, ID 83642
Phone
(208) 888-9393
Fax
(208) 888-9525
NPI assigned
Jun 29, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 20, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA-552 ID Primary

Addresses

Primary practice location

1648 NW 1St Street
Meridian, ID 83642

Mailing address

PO Box 191050
Boise, ID 83719-1050
Phone (208) 955-6522

Other identifiers 1

IdentifierTypeStateIssuer
807240800MedicaidID

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
I20050919001034 ID Practitioner - Physician Assistant 6901830058 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Alliance Medical Group LLCGroup PAC ID 3971544685, 132 clinicians

Practice addresses (Care Compare)

10482 W Carlton Bay Dr
Garden City, ID 83714-5143
Phone (208) 955-6500

11197 W Fairview Ave
Boise, ID 83713-7935
Phone (208) 378-8011

1375 N Happy Valley Rd
Nampa, ID 83687-5280
Phone (208) 809-2869

1474 N Meridian Rd
Kuna, ID 83634-2041
Phone (208) 809-2885

1475 N Cole Rd
Boise, ID 83704-8537
Phone (208) 809-2880

1623 S Wells Ave
Meridian, ID 83642-5040
Phone (208) 489-1450

1895 McGrath Rd
Eagle, ID 83616-6243
Phone (208) 939-8200

1900 W Chinden Blvd
Meridian, ID 83646-6690
Phone (208) 809-2860

6052 W State St
Boise, ID 83703-2739
Phone (208) 947-1947

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
PA-552IDMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Alliance Medical Group, LLC Current Accepting new patients
Alliance Medical Group, LLC CurrentSince Nov 1, 2006 Accepting new patients

Locations

10482 W Carlton Bay Dr
Garden City, ID 83714
Phone (208) 454-9690

1648 NW 1st St
Meridian, ID 83642
Phone (208) 888-9393

Interoperability endpoints

  • Direct secure messaging: jeremy.frix@phmg.eclinicaldirectplus.com

Organizations & group practices 2

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 8

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": "1151539200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1487548800000",
    "number": "1164450862",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 191050",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837191050",
            "telephone_number": "208-955-6522",
            "fax_number": "208-955-6503"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1648 NW 1ST STREET",
            "city": "MERIDIAN",
            "state": "ID",
            "postal_code": "83642",
            "telephone_number": "208-888-9393",
            "fax_number": "208-888-9525"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FRIX",
        "first_name": "JEREMY",
        "middle_name": "DANIEL",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-29",
        "last_updated": "2017-02-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "ID",
            "license": "PA-552",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "807240800",
            "state": "ID"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Meridian, ID

Sources for this page

Verify at the official NPI Registry.