NPIMap

Individual provider Active NPI

Jason Gary Hamblin, M.D.

  • Diagnostic Radiology Physician
  • Boise, ID
National Provider Identifier
1760825442
Registry record updated Dec 4, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
MD2015-0702 Issued in NM
Practice address
1055 N Curtis Rd
Boise, ID 83706-1309
Phone
(208) 367-8855
NPI assigned
Apr 11, 2013
Last updated
Dec 4, 2019By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 4, 2019

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X RS2013-0428 NM
Student in an Organized Health Care Education/Training Program 390200000X NM
Diagnostic Radiology Physician 2085R0202X MD2015-0702 NM Primary

Addresses

Primary practice location

1055 N Curtis Rd
Boise, ID 83706-1309

Mailing address

933 Bradbury Dr SE
Suite 2222
Albuquerque, NM 87106-4374
Phone (505) 272-3120

Other practice location 1

2211 Lomas Blvd NE
Albuquerque, NM 87106-2719
Phone (505) 272-2269

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ID, OR2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20190823001730 ID Practitioner - Diagnostic Radiology 3779718531 Reassigns benefits to 2 organizations
I20190823002682 OR Practitioner - Diagnostic Radiology 3779718531 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
Wayne State University School of Medicine, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Gem State Radiology LLPGroup PAC ID 9335044833, 60 clinicians

Practice addresses (Care Compare)

1055 N Curtis Rd
Boise, ID 83706-1309
Phone (208) 367-2161

2929 E Magic View Dr
Meridian, ID 83642-3560
Phone (208) 954-8127

323 E Riverside Dr
Suite 108
Eagle, ID 83616-6865
Phone (208) 954-8123

3325 Pocahontas Rd
Baker City, OR 97814-1464
Phone (541) 523-8137

351 SW 9TH St
Ontario, OR 97914-2639
Phone (541) 881-7120

4400 E Flamingo Ave
Nampa, ID 83687-9203
Phone (208) 288-4620

875 S Vanguard Way
Suite 100
Meridian, ID 83642-8541
Phone (208) 954-8100

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as group
Quality
100
Improvement activities
40

Merit-based Incentive Payment System (MIPS)

Final score
85.82 of 100Reported as group
Quality
100
Improvement activities
40
Cost
52.72

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
RS2013-0428NMMDStudent in an Organized Health Care Education/Training Program

Practice roles

OrganizationSpecialtyStatusNew patients
Gem State Radiology LLP Diagnostic Radiology CurrentSince Jul 15, 2019 Accepting new patients
Intermountain Medical Imaging LLC Diagnostic Radiology Current Accepting new patients

Locations

1055 N Curtis Rd
Boise, ID 83706
Phone (208) 367-2152

6200 W Emerald St
Boise, ID 83704
Phone (208) 367-3336

927 W Myrtle St
Boise, ID 83702
Phone (208) 367-7510

1717 Arlington Ave
Caldwell, ID 83605
Phone (208) 455-3719

323 E Riverside Dr
Ste 108
Eagle, ID 83616
Phone (208) 367-5700

2929 E Magic View Dr
Meridian, ID 83642
Phone (208) 367-8222

875 S Vanguard Way
Ste 100
Meridian, ID 83642
Phone (208) 954-8100

4300 E Flamingo Ave
Nampa, ID 83687
Phone (208) 367-6416

4424 E Flamingo Ave
#230
Nampa, ID 83687

3325 Pocahontas Rd
Baker City, OR 97814
Phone (541) 523-1797

351 SW 9th St
Ontario, OR 97914
Phone (541) 881-7000

Interoperability endpoints

  • Direct secure messaging: jhamblin1564421@direct.trinity-health.org

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 10

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": "1365638400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1575417600000",
    "number": "1760825442",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "933 BRADBURY DR SE",
            "address_2": "SUITE 2222",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871064374",
            "telephone_number": "505-272-3120",
            "fax_number": "505-272-8060"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1055 N CURTIS RD",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837061309",
            "telephone_number": "208-367-8855"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2211 Lomas Blvd NE",
            "address_purpose": "LOCATION",
            "city": "Albuquerque",
            "state": "NM",
            "postal_code": "871062719",
            "country_code": "US",
            "telephone_number": "505-272-2269",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HAMBLIN",
        "first_name": "JASON",
        "middle_name": "GARY",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-04-11",
        "last_updated": "2019-12-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NM",
            "license": "RS2013-0428",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NM",
            "license": null,
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "NM",
            "license": "MD2015-0702",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boise, ID

Sources for this page

Verify at the official NPI Registry.