Jacob James Inda, MD

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

License

113206 Issued in MT

Practice address

2835 Fort Missoula Rd BLDG 3
Missoula, MT 59804-7423

Phone

(406) 721-5600

NPI assigned

Apr 10, 2016

Last updated

Oct 4, 2022By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in OR

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

Dermatology

Education

University of Wisconsin School of Medicine, 2016

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Mountain West Derm - Blackhart PLLCGroup PAC ID 1153609813, 103 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Ohsu Hospital and Clinics Hospital, Portland, OR, CCN 380009
• St Charles Medical Center - Bend Hospital, Bend, OR, CCN 380047

Merit-based Incentive Payment System (MIPS)

Final score

82.1 of 100Reported as group

Quality

86.66

Promoting interoperability

77

Improvement activities

40

Cost

72.83

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: jinda2486323@wm.providencedirect.org

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.

• Mountain West Derm - Blackhart PLLC

  dba Bend Dermatology Clinic

  • Dermatology Physician
  • Bend, OR
  • NPI 1447764741
  Medicare reassignment Care Compare group NPD
• Bend Dermatology Clinic LLC

  • Dermatology Physician
  • Bend, OR
  • NPI 1649244393
  NPD
• Mountain West Derm-Blackhart, PLLC

  • Dermatology Physician
  • Tigard, OR
  • NPI 1316656994
  NPD
• Mountain West Derm - Blackhart PLLC

  • Dermatology Physician
  • Roseburg, OR
  • NPI 1891467577
  NPD (past)

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

• Cascade Healthcare Community Inc

  dba NW High Desert Sleep Center Bend

  • Sleep Disorder Diagnostic Clinic/Center
  • Bend, OR
  • NPI 1164675963

  Hospital

  Care Compare affiliation
• Oregon Health & Science University

  • General Acute Care Hospital
  • Portland, OR
  • NPI 1609824010
  Care Compare affiliation
• St. Charles Health System, Inc.

  dba St. Charles Bend

  • General Acute Care Hospital
  • Bend, OR
  • NPI 1982621447
  Care Compare affiliation

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

{
    "created_epoch": "1460246400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1664841600000",
    "number": "1275997827",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 7609",
            "city": "MISSOULA",
            "state": "MT",
            "postal_code": "598077609",
            "telephone_number": "406-721-5600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2835 FORT MISSOULA RD BLDG 3",
            "city": "MISSOULA",
            "state": "MT",
            "postal_code": "598047423",
            "telephone_number": "406-721-5600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "INDA",
        "first_name": "JACOB",
        "middle_name": "JAMES",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-04-10",
        "last_updated": "2022-10-04",
        "certification_date": "2022-10-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "MT",
            "license": "113206",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jinda2486323@wm.providencedirect.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "2835 Fort Missoula Rd Bldg 3",
            "city": "Missoula",
            "state": "MT",
            "country_code": "US",
            "postal_code": "598047423",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Elizabeth R Ikeda, DPT
• Maria Ilac, MA
• Maria Christine Iles, DPT
• Illumination Counseling PLLC
• Devra Ann Ince, SWLC
• Inertia Physiotherapy and Movement Studio, PLLC (Inertia Physiotherapy and Movement Studio)
• Infectious Disease Specialists, PC
• Infinite Homecare LLC
• Camryn Elizabeth Ingram
• Inland Imaging LLC - Mt

• Dermatology Physician in Missoula, MT
• Providers in Missoula, MT by specialty
• Dermatology Physician in Montana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 4, 2022; 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.