Individual provider Active NPI

Jason Simpson, PA-C

  • Physician Assistant
  • Idaho Falls, ID
National Provider Identifier
1558090829
Registry record updated Aug 10, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA-2551 Issued in ID
Practice address
2001 S Woodruff Ave Ste 9
Idaho Falls, ID 83404-6371
Phone
(208) 419-3002
Fax
(208) 656-5652
NPI assigned
Jun 10, 2022
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 10, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 12740505-1206 UT
Physician Assistant 363A00000X PA-2551 ID Primary

Addresses

Primary practice location

2001 S Woodruff Ave Ste 9
Idaho Falls, ID 83404-6371

Mailing address

2001 S Woodruff Ave Ste 9
Idaho Falls, ID 83404-6371
Phone (208) 419-3002

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
I20231011003311 ID Practitioner - Physician Assistant 1456733062 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Ascend LLCGroup PAC ID 5496179574, 8 clinicians

Practice addresses (Care Compare)

2001 S Woodruff Ave
Suite 9
Idaho Falls, ID 83404-6371
Phone (208) 419-3002

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PA-2551IDMDPhysician Assistant

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1654819200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1691625600000",
    "number": "1558090829",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2001 S WOODRUFF AVE STE 9",
            "city": "IDAHO FALLS",
            "state": "ID",
            "postal_code": "834046371",
            "telephone_number": "208-419-3002",
            "fax_number": "208-656-5652"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2001 S WOODRUFF AVE STE 9",
            "city": "IDAHO FALLS",
            "state": "ID",
            "postal_code": "834046371",
            "telephone_number": "208-419-3002",
            "fax_number": "208-656-5652"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIMPSON",
        "first_name": "JASON",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-06-10",
        "last_updated": "2023-08-10",
        "certification_date": "2023-08-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "UT",
            "license": "12740505-1206",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "ID",
            "license": "PA-2551",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Idaho Falls, ID

Sources for this page

Verify at the official NPI Registry.