Mary Alice Elizabeth Jaeger, MD

Primary specialty

Sleep Medicine (Family Medicine) PhysicianTaxonomy code 207QS1201X

License

M6380 Issued in ID

Practice address

1717 Lincoln Way Ste 203
Coeur D Alene, ID 83814

Phone

(208) 667-3341

Fax

(208) 664-8973

NPI assigned

Jun 14, 2006

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in ID, WA2 enrollments

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 2

Specialty

Family PracticeAlso: Sleep Medicine

Education

Other, 1989

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Breath of Life Health Care PLLCGroup PAC ID 9032472162, 4 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Northwest Specialty Hospital Hospital, Post Falls, ID, CCN 130066

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: mary.jaegermd.p95@direct.kootenai.nextgenshare.com

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.

• Breath of Life Health Care PLLC

  • Sleep Medicine (Family Medicine) Physician
  • Post Falls, ID
  • NPI 1144720061

  Multi-Specialty, WA

  Medicare reassignment Care Compare group NPD Authorized official
• Medical Imaging Associates of Idaho Falls, Inc

  • Diagnostic Radiology Physician
  • Pocatello, ID
  • NPI 1740225531

  Multi-Specialty

  NPD (past)
• North Idaho Day Surgery LLC

  • General Acute Care Hospital
  • Post Falls, ID
  • NPI 1104824739

  Multi-Specialty

  NPD (past)
• Premier Emergency Physicians of Idaho Medical Group

  • Emergency Medicine Physician
  • Kellogg, ID
  • NPI 1336223379

  Multi-Specialty

  NPD (past)

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

• North Idaho Day Surgery LLC

  • Multi-Specialty Clinic/Center
  • St Maries, ID
  • NPI 1093674301

  Hospital

  Care Compare affiliation
• North Idaho Day Surgery LLC

  • General Acute Care Hospital
  • Post Falls, ID
  • NPI 1104824739
  Care Compare affiliation
• North Idaho Day Surgery LLC

  • Sleep Medicine (Psychiatry & Neurology) Physician
  • Post Falls, ID
  • NPI 1649123589

  Hospital

  Care Compare affiliation

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

{
    "created_epoch": "1150243200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1611619200000",
    "number": "1477596534",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8607 W DRIFTWOOD DR",
            "city": "COEUR D ALENE",
            "state": "ID",
            "postal_code": "838149603",
            "telephone_number": "208-699-7644"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1717 LINCOLN WAY STE 203",
            "city": "COEUR D ALENE",
            "state": "ID",
            "postal_code": "83814",
            "telephone_number": "208-667-3341",
            "fax_number": "208-664-8973"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "12410 E Sinto Ave Ste D",
            "address_purpose": "LOCATION",
            "city": "Spokane Valley",
            "state": "WA",
            "postal_code": "992162199",
            "country_code": "US",
            "telephone_number": "509-892-1313",
            "fax_number": "509-892-1515",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JAEGER",
        "first_name": "MARY ALICE",
        "middle_name": "ELIZABETH",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-06-14",
        "last_updated": "2021-01-26",
        "certification_date": "2021-01-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207QS1201X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine, Sleep Medicine",
            "state": "OK",
            "license": "34507",
            "primary": false
        },
        {
            "code": "207QS1201X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Sleep Medicine",
            "state": "ID",
            "license": "M6380",
            "primary": true
        },
        {
            "code": "207QS1201X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Sleep Medicine",
            "state": "WA",
            "license": "60104935",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "002728300",
            "state": "ID"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Robert Dale Jackson, DNP, FNP-C
• Marileen Ann Jacobs
• Melissa A Jacobson, DC
• Jaeger Curtis Orthodontics
• Ellen Louise Jaeger, PHD LP
• Thomas L Jaeger, DDS
• Shannon Marie Jahns, CSFA
• James J Lee DDS PC
• James P Osmanski II DO
• Cynthia Ann James, COTA

• Sleep Medicine (Family Medicine) Physician in Coeur D Alene, ID
• Providers in Coeur D Alene, ID by specialty
• Sleep Medicine (Family Medicine) Physician in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 26, 2021; 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.