Jeremy Henry Conklin, DO

Primary specialty

Surgical Critical Care PhysicianTaxonomy code 2086S0102X

License

OC-0435 Issued in ID

Practice address

999 N Curtis Rd Ste 415
Boise, ID 83706-1334

Phone

(208) 302-2600

Fax

(208) 302-2625

NPI assigned

May 21, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 4

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in NY, PA, WA, NV, ID, CA6 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 6

Specialty

Thoracic SurgeryAlso: Cardiac Surgery, Critical Care (Intensivists), General Surgery

Education

University of New England, College of Osteo Medicine, 2005

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Intensive Care Consortium IncGroup PAC ID 0244269413, 485 clinicians

Sunrise Mountainview Multispecialty Clinics LLCGroup PAC ID 1759469711, 64 clinicians

Acute Care Surgery Medical Group IncGroup PAC ID 7214006816, 205 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Eastern Idaho Regional Medical Center Hospital, Idaho Falls, ID, CCN 130018
• Mountainview Hospital Hospital, Las Vegas, NV, CCN 290039

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: jeremy.conklin.p1@direct.smmg.nextgenshare.com
• Direct secure messaging: jconklin3201413@direct.trinity-health.org
• Direct secure messaging: jconklin163794@direct.renown.org
• Direct secure messaging: jconklin434681@direct.peacehealth.org

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.

• Acute Care Surgery Medical Group, Inc.

  • Surgery Physician
  • Sacramento, CA
  • NPI 1700069549

  CA, Surgical Critical Care

  Medicare reassignment Care Compare group NPD
• Intensive Care Consortium Inc

  • Specialist
  • Aventura, FL
  • NPI 1629019062

  Critical Care Medicine, ID

  Medicare reassignment Care Compare group NPD
• Sunrise Mountainview Multispecialty Clinics, LLC

  • Neurology Physician
  • Las Vegas, NV
  • NPI 1043402522

  Critical Care Medicine, NV

  Medicare reassignment Care Compare group NPD
• Saint Alphonsus Regional Medical Center Inc

  • Psychologist
  • Boise, ID
  • NPI 1649357716

  ID

  Medicare reassignment NPD
• Bay Area Hospital District

  • General Acute Care Hospital
  • Coos Bay, OR
  • NPI 1225016561

  OR

  Medicare reassignment NPD
• New York University

  • Cardiovascular Disease Physician
  • Boynton Beach, FL
  • NPI 1285826438

  NY

  Medicare reassignment NPD
• RCCH Trios Health LLC

  • Internal Medicine Physician
  • Kennewick, WA
  • NPI 1831682806

  WA

  Medicare reassignment NPD
• Tower Health Medical Group

  • Internal Medicine Physician
  • Birdsboro, PA
  • NPI 1609291350

  PA

  Medicare reassignment NPD
• Yakima Valley Memorial Physicians

  • General Acute Care Hospital
  • Yakima, WA
  • NPI 1306933940

  WA

  Medicare reassignment NPD
• Saint Alphonsus Regional Medical Center Inc

  • Psychiatric Hospital Unit
  • Boise, ID
  • NPI 1770687857
  NPD
• Saint Alphonsus Regional Medical Center Inc

  • Family Medicine Physician
  • Caldwell, ID
  • NPI 1861676298
  NPD
• Bay Area Hospital District

  • Home Health Agency
  • North Bend, OR
  • NPI 1215018197
  NPD

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

• Eastern Idaho Health Services Inc

  • General Acute Care Hospital
  • Idaho Falls, ID
  • NPI 1225082209

  Hospital

  Care Compare affiliation
• Sunrise Mountainview Hospital, Inc.

  • General Acute Care Hospital
  • Las Vegas, NV
  • NPI 1104870187

  Hospital

  Care Compare affiliation

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

{
    "created_epoch": "1148169600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1709596800000",
    "number": "1700830882",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "747 BROADWAY",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981224307",
            "telephone_number": "206-215-2520",
            "fax_number": "206-215-6364"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "999 N CURTIS RD STE 415",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837061334",
            "telephone_number": "208-302-2600",
            "fax_number": "208-302-2625"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1010 Three Springs Blvd",
            "address_purpose": "LOCATION",
            "city": "Durango",
            "state": "CO",
            "postal_code": "813018296",
            "country_code": "US",
            "telephone_number": "970-764-2750",
            "fax_number": "970-764-2778",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "747 Broadway",
            "address_purpose": "LOCATION",
            "city": "Seattle",
            "state": "WA",
            "postal_code": "981224379",
            "country_code": "US",
            "telephone_number": "206-215-2520",
            "fax_number": "206-215-6364",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CONKLIN",
        "first_name": "JEREMY",
        "middle_name": "HENRY",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-21",
        "last_updated": "2024-03-05",
        "certification_date": "2024-03-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2086S0102X",
            "taxonomy_group": "",
            "desc": "Surgery, Surgical Critical Care",
            "state": "WA",
            "license": "OP60816242",
            "primary": false
        },
        {
            "code": "2086S0102X",
            "taxonomy_group": "",
            "desc": "Surgery, Surgical Critical Care",
            "state": "CO",
            "license": "CDR.0002122",
            "primary": false
        },
        {
            "code": "364SC0200X",
            "taxonomy_group": "",
            "desc": "Clinical Nurse Specialist, Critical Care Medicine",
            "state": "CO",
            "license": "CDR.0002122",
            "primary": false
        },
        {
            "code": "2086S0102X",
            "taxonomy_group": "",
            "desc": "Surgery, Surgical Critical Care",
            "state": "ID",
            "license": "OC-0435",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1700830882",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• J Brett Comstock, DDS
• Stephen Dwight Comstock, R.PH.
• Confluence Functional and Integrative Psychiatry LLC
• Confluence Health Psychology PLLC
• Congruence Mental Health LLC
• Katy Lynn Conklin
• Matthew John Conklin, M.D.
• Nancy Conklin, PT
• Shelly S Conley-Durkin, LCSW
• Samantha A Conley, FNP

• All providers in Boise, ID
• Surgical Critical Care Physician in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 5, 2024; 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.