Jennifer T Shalz, MD
Individual provider Active NPI Internal Medicine Physician · Meridian, ID
NPI 1245346303 · NPPES record last updated Mar 7, 2014
Key facts
- NPI
- 1245346303
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Internal Medicine Physician 207R00000X
- License
- M9899 (ID)
- Practice address
- 3525 E Louise Dr
Suite 500
Meridian, ID 83642-6302 - Phone
- (208) 706-7050
- Fax
- (208) 706-7059
- NPI assigned
- Aug 22, 2006
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 7
Hospital & facility affiliations 3
Medicare Care Compare profile
- Specialty
- Internal Medicine
- Education
- Tufts University School of Medicine, 1994
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
- St Lukes Clinic-Treasure Valley LLC
Practice addresses (Care Compare)
608 W Hays St
Boise, ID 83702-5511
Phone (208) 381-5970
610 W Hays St
Boise, ID 83702-5511
Phone (208) 381-5970
Hospital & facility affiliations
- St Luke'S Regional Medical Center
- St Luke'S Nampa Medical Center
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in ID
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20080424000359 | ID | Practitioner - Internal Medicine | 4981782497 | Reassigns benefits to 4 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| M9899 | ID | MD | Internal Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Northwest Radiation Oncology PA | Past | Accepting new patients |
Interoperability endpoints
- jshalz18604@direct.slhs.org
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | M9899 | ID | Yes |
Addresses
Primary practice location
3525 E Louise Dr
Suite 500
Meridian, ID 83642-6302
Mailing address
190 E Bannock St
Boise, ID 83712-6241
Phone (208) 381-2222
Other providers in Meridian, ID
- Benjamin Seymour
- Brenna Mae Shackelford
- Dana Shah
- Kierstin Elizabeth Shahtout
- April Louise Shalz
- Amit Sharma
- Jessica Kelly Sharma
- Johnathan August Sharrette
- Shaun Mar DC LLC
- Kyla Ashley Shaver
All providers in Meridian, ID · Internal Medicine Physician in Idaho
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 7, 2014. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.