Jacob Wayne Moss, M.D., J.D.

Primary specialty

General Practice PhysicianTaxonomy code 208D00000X

License

M-14547 Issued in ID

Practice address

335 E Main St Ste 1
Saint Anthony, ID 83445-1546

Phone

(208) 356-4900

Fax

(208) 624-4116

NPI assigned

Apr 3, 2013

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in ID

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

General Practice

Education

Southern Illinois University School of Medicine, 2013

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Teton Valley Health Care IncGroup PAC ID 3870744956, 31 clinicians

Upper Valley Community Health Services IncGroup PAC ID 4385725282, 31 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Madison Memorial Hospital Hospital, Rexburg, ID, CCN 130025

Medicare enrollment (NPD)

Enrolled

Credentials

Juris Doctor, Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: jacob.moss.1@15468.direct.athenahealth.com

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.

• Upper Valley Community Health Services Inc

  • Federally Qualified Health Center (FQHC)
  • Saint Anthony, ID
  • NPI 1972792489

  ID

  Medicare reassignment Care Compare group NPD
• Upper Valley Community Health Services Inc

  • Federally Qualified Health Center (FQHC)
  • Saint Anthony, ID
  • NPI 1396507190
  Care Compare group NPD
• Upper Valley Community Health Services, Inc.

  • Federally Qualified Health Center (FQHC)
  • Dubois, ID
  • NPI 1649142712
  Care Compare group NPD
• Upper Valley Community Health Services Inc

  • Federally Qualified Health Center (FQHC)
  • Rexburg, ID
  • NPI 1124403258
  Care Compare group NPD (past)
• Upper Valley Community Health Services Inc

  • Federally Qualified Health Center (FQHC)
  • Idaho Falls, ID
  • NPI 1932961810
  Care Compare group NPD (past)
• Teton Valley Health Care Inc

  • Rural Health Clinic/Center
  • Driggs, ID
  • NPI 1013264183
  Care Compare group
• Teton Valley Health Care Inc

  • Critical Access Hospital
  • Driggs, ID
  • NPI 1477809622
  Care Compare group
• Teton Valley Health Care, Inc

  • Medicare Defined Swing Bed Hospital Unit
  • Driggs, ID
  • NPI 1053669598
  Care Compare group
• Teton Valley Health Care, Inc

  • Rural Health Clinic/Center
  • Victor, ID
  • NPI 1801143029
  Care Compare group
• Upper Valley Community Health Services Inc

  • Federally Qualified Health Center (FQHC)
  • Saint Anthony, ID
  • NPI 1831721398
  Care Compare group

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

• Madison Co Memorial Hospital

  • Obstetrics & Gynecology Physician
  • Rexburg, ID
  • NPI 1073154266

  Hospital

  Care Compare affiliation
• Madison Co Memorial Hospital

  • General Acute Care Hospital
  • Rexburg, ID
  • NPI 1992747570

  Hospital

  Care Compare affiliation

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

{
    "created_epoch": "1364947200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1760486400000",
    "number": "1205179751",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 18",
            "city": "SAINT ANTHONY",
            "state": "ID",
            "postal_code": "834450018",
            "telephone_number": "208-356-4900",
            "fax_number": "208-624-4112"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "335 E MAIN ST STE 1",
            "city": "SAINT ANTHONY",
            "state": "ID",
            "postal_code": "834451546",
            "telephone_number": "208-356-4900",
            "fax_number": "208-624-4116"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "72 S 1st E Ste 101",
            "address_purpose": "LOCATION",
            "city": "Rexburg",
            "state": "ID",
            "postal_code": "834401902",
            "country_code": "US",
            "telephone_number": "208-356-4900",
            "fax_number": "208-356-3724",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3724 Woodking Dr Ste 1",
            "address_purpose": "LOCATION",
            "city": "Idaho Falls",
            "state": "ID",
            "postal_code": "83404",
            "country_code": "US",
            "telephone_number": "208-356-4900",
            "fax_number": "208-612-6118",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MOSS",
        "first_name": "JACOB",
        "middle_name": "WAYNE",
        "name_prefix": "Mr.",
        "credential": "M.D., J.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-04-03",
        "last_updated": "2025-10-15",
        "certification_date": "2025-10-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "ID",
            "license": "M-14547",
            "primary": true
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "GA",
            "license": "TM190",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• I Care Medical Clinic PA
• Neil L Kunz, D.M.D.
• Gabriel Aaron Lenz, DMD
• Katie M McFarland, LCSW
• Whittney Kay Miller, FNP-C
• Jacob Nelson, DO
• Northfork Developmental Services Inc.
• Scott Nye
• Amy I Ohs, LCSW
• Richard Palmer, LPC

• All providers in Saint Anthony, ID
• General Practice Physician in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 15, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.