Active NPI
Brant Jaouen, M.D.
- Emergency Medicine Physician
- Boise, ID
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Emergency Medicine Physician
- License
- MC-1553
- Practice address
- 190 E Bannock St
Boise, ID 83712-6241 - Phone
- (208) 381-2235
- NPI assigned
- Apr 15, 2016
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Emergency Medicine Physician | 207P00000X | MC-1553 | ID | Primary |
| Emergency Medicine Physician | 207P00000X | 56434 | AZ |
Addresses
Primary practice location
190 E Bannock St
Boise, ID 83712-6241
Mailing address
190 E Bannock St
Boise, ID 83712-6241
Phone (208) 381-8752
Other practice location 1
2601 E Roosevelt St
Phoenix, AZ 85008-4973
Phone (602) 344-5808
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in AZ, ID
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 2
Care Compare profile
Medicare Care Compare- Specialty
- Emergency Medicine
- Education
- Other, 2016
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
520 S Eagle Rd
Meridian, ID 83642-6351
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
Merit-based Incentive Payment System (MIPS)
- Final score
- 87.3 of 100
- Quality
- 81.29
- Promoting interoperability
- 100
- Improvement activities
- 40
- Cost
- 76.37
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| District Medical Group, Inc | Current | Accepting new patients | |
| District Medical Group, Inc | Current | Accepting new patients | |
| District Medical Group, Inc | Emergency Medicine | Current | Accepting new patients |
| St Lukes Clinic-Treasure Valley LLC | Emergency Medicine | Current | Accepting new patients |
| District Medical Group, Inc | Family Medicine | Past | Accepting new patients |
Locations
2601 E Roosevelt St
Phoenix, AZ 85008
Phone (602) 220-0298
2929 E Thomas Rd
Phoenix, AZ 85016
Phone (602) 470-5043
5102 W Campbell Ave
Phoenix, AZ 85031
Phone (623) 848-5000
3141 N 3rd Ave
Phoenix, AZ 85013
Phone (602) 914-1520
190 E Bannock St
Boise, ID 83712
Phone (208) 381-2378
610 W Hays St
Boise, ID 83702
Phone (208) 345-3530
Interoperability endpoints
- bjaouen123221@direct.valleywisehealth.org
Organizations & group practices 5
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.
-
- Family Medicine Physician
- Boise, ID
- NPI 1326336058
Emergency Medicine
-
- Anatomic Pathology & Clinical Pathology Physician
- Phoenix, AZ
- NPI 1336472448
-
- Emergency Medicine Physician
- Phoenix, AZ
- NPI 1144624339
-
- Endocrinology, Diabetes & Metabolism Physician
- Phoenix, AZ
- NPI 1992038004
Hospital & facility affiliations 3
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Boise, ID
- NPI 1770586794
-
- General Acute Care Hospital
- Nampa, ID
- NPI 1831590660
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1460678400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1662940800000",
"number": "1417301433",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "190 E BANNOCK ST",
"city": "BOISE",
"state": "ID",
"postal_code": "837126241",
"telephone_number": "208-381-8752"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "190 E BANNOCK ST",
"city": "BOISE",
"state": "ID",
"postal_code": "837126241",
"telephone_number": "208-381-2235"
}
],
"practiceLocations": [
{
"address_1": "2601 E Roosevelt St",
"address_purpose": "LOCATION",
"city": "Phoenix",
"state": "AZ",
"postal_code": "850084973",
"country_code": "US",
"telephone_number": "602-344-5808",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "JAOUEN",
"first_name": "BRANT",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2016-04-15",
"last_updated": "2022-09-12",
"certification_date": "2022-09-12",
"status": "A"
},
"taxonomies": [
{
"code": "207P00000X",
"taxonomy_group": "",
"desc": "Emergency Medicine",
"state": "ID",
"license": "MC-1553",
"primary": true
},
{
"code": "207P00000X",
"taxonomy_group": "",
"desc": "Emergency Medicine",
"state": "AZ",
"license": "56434",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Boise, ID
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 12, 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.