NPIMap

Individual provider Active NPI

Jessica Elaine Fu, M.D.

  • Obstetrics & Gynecology Physician
  • Caldwell, ID
National Provider Identifier
1710185111
Registry record updated Aug 7, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
M-11303 Issued in ID
Practice address
315 Elm Street
Ste 310
Caldwell, ID 83605
Phone
(208) 454-2035
Fax
(208) 454-1065
NPI assigned
Jul 6, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 7, 2014

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X M-11303 ID Primary
Student in an Organized Health Care Education/Training Program 390200000X LL1756 NV

Addresses

Primary practice location

315 Elm Street
Ste 310
Caldwell, ID 83605

Mailing address

315 Elm Street
Ste 310
Caldwell, ID 83605
Phone (208) 454-2035

Other identifiers 1

IdentifierTypeStateIssuer
LL1756OtherNVNV MEDICAL LIC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ID
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110912000627 ID Practitioner - Obstetrics/Gynecology 7618148255 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Obstetrics/Gynecology
Education
University of Nevada School of Medicine, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Women'S Health Associates, PLLCGroup PAC ID 4082630587, 19 clinicians

Practice addresses (Care Compare)

333 N 1St St
Suite 240
Boise, ID 83702-6132
Phone (208) 338-8900

Hospital & facility affiliations

  • Saint Alphonsus Regional Medical Center Hospital, Boise, ID, CCN 130007
  • St Luke'S Regional Medical Center Hospital, Boise, ID, CCN 130006

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
M-11303IDMDObstetrics & Gynecology Physician
LL1756NVMDStudent in an Organized Health Care Education/Training Program

Practice roles

OrganizationSpecialtyStatusNew patients
Women'S Health Associates, PLLC Obstetrics & Gynecology CurrentSince Mar 9, 2022 Accepting new patients
St Lukes Regional Medical Center Past Accepting new patients
T-Medica Mobil Anesthesia Inc. PastSince Apr 17, 2022 Accepting new patients

Locations

333 N 1st St
Ste 240
Boise, ID 83702
Phone (208) 338-8900

3080 E Gentry Way
Ste 200
Meridian, ID 83642
Phone (208) 338-8900

Organizations & group practices 3

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 7

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": "1183680000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1407369600000",
    "number": "1710185111",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "315 ELM STREET",
            "address_2": "STE 310",
            "city": "CALDWELL",
            "state": "ID",
            "postal_code": "83605",
            "telephone_number": "208-454-2035",
            "fax_number": "208-454-1065"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "315 ELM STREET",
            "address_2": "STE 310",
            "city": "CALDWELL",
            "state": "ID",
            "postal_code": "83605",
            "telephone_number": "208-454-2035",
            "fax_number": "208-454-1065"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FU",
        "first_name": "JESSICA",
        "middle_name": "ELAINE",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-07-06",
        "last_updated": "2014-08-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "ID",
            "license": "M-11303",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NV",
            "license": "LL1756",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NV MEDICAL LIC",
            "identifier": "LL1756",
            "state": "NV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Caldwell, ID

Sources for this page

Verify at the official NPI Registry.