Individual provider Active NPI

Jared Mudge, PA-C

  • Medical Physician Assistant
  • Post Falls, ID
National Provider Identifier
1679398929
Registry record updated Jan 22, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
5761672 Issued in ID
Practice address
1551 E Mullan Ave Ste 200B
Post Falls, ID 83854-9005
Phone
(208) 262-2213
Fax
(208) 262-2214
NPI assigned
Nov 21, 2024
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 22, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X 5761672 ID Primary

Addresses

Primary practice location

1551 E Mullan Ave Ste 200B
Post Falls, ID 83854-9005

Mailing address

1593 E Polston Ave
Post Falls, ID 83854-5326
Phone (208) 262-2300

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
I20250618003133 ID Practitioner - Physician Assistant 8527579275 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
North Idaho Day Surgery LLCGroup PAC ID 0840101218, 87 clinicians

Practice addresses (Care Compare)

1551 E Mullan Ave
Suite 200B
Post Falls, ID 83854-9005
Phone (208) 262-2213

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
North Idaho Day Surgery LLC CurrentSince Feb 1, 2026 Accepting new patients

Locations

1593 E Polston Ave
Post Falls, ID 83854
Phone (208) 262-2300

1551 E Mullan Ave
Ste 200B
Post Falls, ID 83854
Phone (208) 262-2213

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 4

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": "1732147200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1769040000000",
    "number": "1679398929",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1593 E POLSTON AVE",
            "city": "POST FALLS",
            "state": "ID",
            "postal_code": "838545326",
            "telephone_number": "208-262-2300",
            "fax_number": "208-262-2390"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1551 E MULLAN AVE STE 200B",
            "city": "POST FALLS",
            "state": "ID",
            "postal_code": "838549005",
            "telephone_number": "208-262-2213",
            "fax_number": "208-262-2214"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MUDGE",
        "first_name": "JARED",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-11-21",
        "last_updated": "2026-01-22",
        "certification_date": "2026-01-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "ID",
            "license": "5761672",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Post Falls, ID

Sources for this page

Verify at the official NPI Registry.