Individual provider Active NPI

Jordan Gunkel, PA-C

  • Physician Assistant
  • Boise, ID
National Provider Identifier
1548790264
Registry record updated May 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA-1800 Issued in ID
Practice address
2242 E Riverwalk Dr Ste 200
Boise, ID 83706-5483
Phone
(208) 495-4145
NPI assigned
Jun 14, 2017
Last updated
May 13, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 13, 2026

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X NU
Physician Assistant 363A00000X PA-1800 ID Primary
Medical Physician Assistant 363AM0700X NU

Addresses

Primary practice location

2242 E Riverwalk Dr Ste 200
Boise, ID 83706-5483

Mailing address

2242 E Riverwalk Dr Ste 200
Boise, ID 83706-5483
Phone (208) 495-4145

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ID
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220629000756 ID Practitioner - Physician Assistant 7618241647 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
87.3 of 100Reported as group
Quality
81.29
Promoting interoperability
100
Improvement activities
40
Cost
76.37

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PA-1800IDMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
St Lukes Clinic-Treasure Valley LLC CurrentSince Apr 16, 2022 Accepting new patients

Locations

190 E Bannock St
Boise, ID 83712
Phone (208) 381-2378

417 S 6th St
Boise, ID 83702
Phone (208) 577-4423

610 W Hays St
Boise, ID 83702
Phone (208) 345-3530

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1497398400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1778630400000",
    "number": "1548790264",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2242 E RIVERWALK DR STE 200",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837065483",
            "telephone_number": "208-495-4145"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2242 E RIVERWALK DR STE 200",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837065483",
            "telephone_number": "208-495-4145"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GUNKEL",
        "first_name": "JORDAN",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-06-14",
        "last_updated": "2026-05-13",
        "certification_date": "2026-05-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "ID",
            "license": "PA-1800",
            "primary": true
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boise, ID

Sources for this page

Verify at the official NPI Registry.