NPIMap

Individual provider Active NPI

Jennifer Lee Carlsen, PA-C

  • Physician Assistant
  • Boise, ID
National Provider Identifier
1235434010
Registry record updated Nov 13, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA 887 Issued in ID
Practice address
6051 W Emerald St
Boise, ID 83704-8969
Phone
(208) 302-5150
Fax
(208) 302-5155
NPI assigned
Jan 25, 2011
Last updated
Nov 13, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 13, 2024

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 887 ID Primary

Addresses

Primary practice location

6051 W Emerald St
Boise, ID 83704-8969

Mailing address

PO Box 190930
Boise, ID 83719-0930
Phone (208) 367-5170

Other practice location 1

1859 S Topaz Way Ste 106
Meridian, ID 83642-4401
Phone (208) 672-4640

Other practice location 2

3277 E Louise Dr Ste 150
Meridian, ID 83642-9373
Phone (208) 706-5127

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ID, UT2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20110317000104 ID Practitioner - Physician Assistant 8022290709 Reassigns benefits to 4 organizations
I20240424002109 UT Practitioner - Physician Assistant 8022290709 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
St Lukes Clinic-Treasure Valley LLCGroup PAC ID 4981878402, 1,155 clinicians

Practice addresses (Care Compare)

10717 W State St
Star, ID 83669-6046
Phone (208) 302-6300

11035 Karcher Rd
Nampa, ID 83651-8200
Phone (208) 302-2100

3025 W Cherry LN
Meridian, ID 83642-8531

3277 E Louise Dr
Suite 150
Meridian, ID 83642-9373
Phone (208) 706-8346

6022 W Emerald St
Boise, ID 83704-8855
Phone (208) 367-4603

608 W Hays St
Boise, ID 83702-5511
Phone (208) 381-5970

6094 W Emerald St
Boise, ID 83704-8855
Phone (208) 302-1000

610 W Hays St
Boise, ID 83702-5511
Phone (208) 381-5970

867 S Vanguard Way
Meridian, ID 83642-7552
Phone (208) 302-7950

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
87.3 of 100Reported as group
Quality
81.29
Promoting interoperability
100
Improvement activities
40
Cost
76.37

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PA 887IDMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Ihc Health Services, Inc. CurrentSince Apr 8, 2024 Accepting new patients
Saint Alphonsus Medical Center- Ontario Inc CurrentSince Jan 1, 2025 Accepting new patients
Ihc Health Services Inc CurrentSince Apr 8, 2024 Accepting new patients
Elaine Key MD PLLC CurrentSince Apr 1, 2023 Accepting new patients
Idaho Spine & Pain PLLC CurrentSince Apr 1, 2023 Accepting new patients
St Lukes Clinic-Treasure Valley LLC CurrentSince Jun 27, 2024 Accepting new patients
Ihc Health Services Inc Transplant Surgery CurrentSince May 11, 2024 Accepting new patients
Saint Alphonsus Regional Medical Center Inc Orthopaedic Surgery CurrentSince Jan 1, 2025 Accepting new patients
Saint Alphonsus Medical Center- Ontario Inc CurrentSince Jan 1, 2025 Accepting new patients
Direct Surgical Assist PA Physician Assistant Past Accepting new patients
Ihc Health Services Inc Past Accepting new patients
St Lukes Regional Medical Center Past Accepting new patients

Locations

1075 N Curtis Rd
Ste 101
Boise, ID 83706
Phone (208) 302-2800

6051 W Emerald St
Boise, ID 83704
Phone (208) 302-5100

610 W Hays St
Boise, ID 83702
Phone (208) 345-3530

910 NW 16th St
Ste 101
Fruitland, ID 83619
Phone (208) 452-8000

1859 S Topaz Way
Ste 106
Meridian, ID 83642
Phone (208) 475-3720

3277 E Louise Dr
Ste 150
Meridian, ID 83642
Phone (208) 388-7239

444 Hospital Way
Pocatello, ID 83201
Phone (208) 232-6214

5171 S Cottonwood St
Ste 210
Salt Lake City, UT 84107

400 C St
Salt Lake Cty, UT 84143
Phone (435) 688-4080

Interoperability endpoints

  • Direct secure messaging: jcarlsen3868234@direct.trinity-health.org

Organizations & group practices 14

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.

View all 14

Hospital & facility affiliations 13

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

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1295913600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1731456000000",
    "number": "1235434010",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 190930",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837190930",
            "telephone_number": "208-367-5170",
            "fax_number": "208-367-5180"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6051 W EMERALD ST",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837048969",
            "telephone_number": "208-302-5150",
            "fax_number": "208-302-5155"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1859 S Topaz Way Ste 106",
            "address_purpose": "LOCATION",
            "city": "Meridian",
            "state": "ID",
            "postal_code": "836424401",
            "country_code": "US",
            "telephone_number": "208-672-4640",
            "fax_number": "208-957-6300",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3277 E Louise Dr Ste 150",
            "address_purpose": "LOCATION",
            "city": "Meridian",
            "state": "ID",
            "postal_code": "836429373",
            "country_code": "US",
            "telephone_number": "208-706-5127",
            "fax_number": "208-706-5854",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CARLSEN",
        "first_name": "JENNIFER",
        "middle_name": "LEE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-01-25",
        "last_updated": "2024-11-13",
        "certification_date": "2024-11-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "ID",
            "license": "PA 887",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boise, ID

Sources for this page

Verify at the official NPI Registry.