Individual provider Active NPI

Jason Smith, PA

  • Physician Assistant
  • Meridian, ID
National Provider Identifier
1699290296
Registry record updated Jun 4, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA-2116 Issued in ID
Practice address
1618 S Millenium Way Ste 100
Meridian, ID 83642-6457
Phone
(208) 884-3376
NPI assigned
Aug 4, 2017
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 4, 2025

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 PA-2116 ID Primary

Addresses

Primary practice location

1618 S Millenium Way Ste 100
Meridian, ID 83642-6457

Mailing address

1618 S Millenium Way Ste 100
Meridian, ID 83642-6457
Phone (208) 884-3376

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address jsmith@adawest.emadirect.md

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
I20211229001127 ID Practitioner - Physician Assistant 4183998099 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ada West Dermatology, P.C.Group PAC ID 1153341532, 26 clinicians

Practice addresses (Care Compare)

1618 S Millenium Way
Suite 100
Meridian, ID 83642-6457
Phone (208) 884-3376

Merit-based Incentive Payment System (MIPS)

Final score
77.64 of 100Reported as group
Quality
70.07
Promoting interoperability
100
Improvement activities
40
Cost
55.38

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PA-2116IDMDPhysician Assistant

Interoperability endpoints

  • Direct secure messaging: jsmith@adawest.emadirect.md

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": "1501804800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1748995200000",
    "number": "1699290296",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1618 S MILLENIUM WAY STE 100",
            "city": "MERIDIAN",
            "state": "ID",
            "postal_code": "836426457",
            "telephone_number": "208-884-3376"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1618 S MILLENIUM WAY STE 100",
            "city": "MERIDIAN",
            "state": "ID",
            "postal_code": "836426457",
            "telephone_number": "208-884-3376"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "JASON",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-08-04",
        "last_updated": "2025-06-04",
        "certification_date": "2025-06-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "ID",
            "license": "PA-2116",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jsmith@adawest.emadirect.md",
            "affiliation": "N",
            "address_1": "1618 S Millenium Way Ste 100",
            "city": "Meridian",
            "state": "ID",
            "country_code": "US",
            "postal_code": "836426457",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Meridian, ID

Sources for this page

Verify at the official NPI Registry.