NPIMap

Individual provider Active NPI

Jared Harris Moser, PA-C

  • Physician Assistant
  • Garden Valley, ID
National Provider Identifier
1447818521
Registry record updated Jun 3, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
856 Banks Lowman Rd
Garden Valley, ID 83622-8102
Phone
(208) 462-3533
NPI assigned
Jun 3, 2019
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 3, 2019

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 Primary

Addresses

Primary practice location

856 Banks Lowman Rd
Garden Valley, ID 83622-8102

Mailing address

1752 E 2350 S
Gooding, ID 83330-5238
Phone (307) 887-3975

Other identifiers 1

IdentifierTypeStateIssuer
NAOtherNA

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20191112002141 ID Practitioner - Physician Assistant 4486086543 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2019
Medicare assignment
May accept Medicare assignment
Telehealth
Offers telehealth services
Group practices
Garden Valley Family Medicine PCGroup PAC ID 0648296814, 6 clinicians

Practice addresses (Care Compare)

856 Banks Lowman Rd
Garden Valley, ID 83622-8102
Phone (208) 462-5533

Hospital & facility affiliations

  • St Luke'S Regional Medical Center Hospital, Boise, ID, CCN 130006
  • Valor Health Hospital, Emmett, ID, CCN 131318
  • Saint Alphonsus Regional Medical Center Hospital, Boise, ID, CCN 130007
  • St Luke'S Nampa Medical Center Hospital, Nampa, ID, CCN 130071

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Achieve Physical Therapy PLLC Past Accepting new patients

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/FJDCBD/Endpoint/FJDCBD

Organizations & group practices 2

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.

Hospital & facility affiliations 11

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

NPI Registry JSON

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

{
    "created_epoch": "1559520000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1559520000000",
    "number": "1447818521",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1752 E 2350 S",
            "city": "GOODING",
            "state": "ID",
            "postal_code": "833305238",
            "telephone_number": "307-887-3975"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "856 BANKS LOWMAN RD",
            "city": "GARDEN VALLEY",
            "state": "ID",
            "postal_code": "836228102",
            "telephone_number": "208-462-3533"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOSER",
        "first_name": "JARED",
        "middle_name": "HARRIS",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-06-03",
        "last_updated": "2019-06-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NA",
            "identifier": "NA",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Garden Valley, ID

Sources for this page

Verify at the official NPI Registry.