Individual provider Active NPI

Jacob Hammer

  • Certified Registered Nurse Anesthetist
  • Boise, ID
National Provider Identifier
1770083529
Registry record updated Feb 19, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
37732 Issued in ID
Practice address
2537 W State St Ste 200
Boise, ID 83702-2200
Phone
(208) 336-0895
NPI assigned
Feb 19, 2018
Last updated
Feb 19, 2018By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 19, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X 37732 ID Primary

Addresses

Primary practice location

2537 W State St Ste 200
Boise, ID 83702-2200

Mailing address

3755 W Idaho Blvd
Emmett, ID 83617-8922
Phone (208) 369-6262

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ID

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180618002642 ID Practitioner - Certified Registered Nurse Anesthetist (Crna) 2961757877 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Innovative Anesthesia Pain and Wellness PLLCGroup PAC ID 7214336882, 11 clinicians
Anesthesiology Consultants of Treasure Valley PLLCGroup PAC ID 4981661196, 27 clinicians

Practice addresses (Care Compare)

3090 E Gentry Way
Suite 100
Meridian, ID 83642-3548
Phone 208525209018

8800 W Emerald St
Boise, ID 83704-8205
Phone (208) 373-5000

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Registered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Anesthesia Associates of Boise, P.a. CurrentSince Jun 1, 2018 Accepting new patients
Anesthesiology Consultants of Treasure Valley PLLC CurrentSince Jan 1, 2025 Accepting new patients
Innovative Anesthesia Pain & Wellness PLLC Nurse Anesthetist, Certified Registered CurrentSince Aug 16, 2025 Accepting new patients

Locations

190 E Bannock St
Boise, ID 83712
Phone (208) 381-2235

2537 W State St
Ste 200
Boise, ID 83702
Phone (208) 336-0895

338 E Bannock St
Boise, ID 83712
Phone (208) 336-0895

8800 W Emerald St
Boise, ID 83704
Phone (208) 373-5000

1000 State St
McCall, ID 83638
Phone (208) 634-2221

3090 E Gentry Way
Ste 100
Meridian, ID 83642
Phone (208) 288-1600

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

Hospital & facility affiliations 6

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": "1518998400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1518998400000",
    "number": "1770083529",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3755 W IDAHO BLVD",
            "city": "EMMETT",
            "state": "ID",
            "postal_code": "836178922",
            "telephone_number": "208-369-6262"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2537 W STATE ST STE 200",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837022200",
            "telephone_number": "208-336-0895"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAMMER",
        "first_name": "JACOB",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-02-19",
        "last_updated": "2018-02-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "ID",
            "license": "37732",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boise, ID

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 19, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.