Individual provider Active NPI

Jeffrey Slavich, P.A.

  • Physician Assistant
  • Pocatello, ID
National Provider Identifier
1780694000
Registry record updated Dec 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA-2608 Issued in ID
Practice address
2850 Olympus Drive
Pocatello, ID 83201-2271
Phone
(208) 239-1905
Fax
(208) 239-3696
NPI assigned
Aug 9, 2006
Last updated
Dec 11, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 11, 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-2608 ID Primary

Addresses

Primary practice location

2850 Olympus Drive
Pocatello, ID 83201-2271

Mailing address

P.O. Box 4168
Pocatello, ID 83205-4168
Phone (208) 239-1035

Other practice location 1

1 Medical Center Dr
Lebanon, NH 03756-1000
Phone (603) 650-8622

Other identifiers 3

IdentifierTypeStateIssuer
02808886MedicaidNY
6704808MedicaidVT
3124453MedicaidNH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY, ID2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20061010000367 NY Practitioner - Physician Assistant 7810993110 Reassigns benefits to 1 organization
I20240111003312 ID Practitioner - Physician Assistant 7810993110 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Pocatello Health Services LLCGroup PAC ID 6608927637, 171 clinicians

Practice addresses (Care Compare)

777 Hospital Way
Pocatello, ID 83201-5175

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
011256NYMDOccupational Therapist
PA-2608IDMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Pocatello Health Services, LLC CurrentSince Nov 20, 2023 Accepting new patients
Pocatello Hospital LLC Past Accepting new patients
Cny Diagnostic Imaging Associates Past Accepting new patients

Locations

777 Hospital Way
Ste 202
Pocatello, ID 83201
Phone (208) 239-2640

2850 Olympus Dr
Pocatello, ID 83201
Phone (208) 239-2273

Interoperability endpoints

  • Direct secure messaging: jslavich403632@direct.dartmouth-hitchcock.org
  • Direct secure messaging: jslavich887002@ahs.direct-ci.com

Organizations & group practices 5

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 2

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": "1155081600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1765411200000",
    "number": "1780694000",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "P.O. BOX 4168",
            "city": "POCATELLO",
            "state": "ID",
            "postal_code": "832054168",
            "telephone_number": "208-239-1035",
            "fax_number": "208-239-3626"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2850 OLYMPUS DRIVE",
            "city": "POCATELLO",
            "state": "ID",
            "postal_code": "832012271",
            "telephone_number": "208-239-1905",
            "fax_number": "208-239-3696"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1 Medical Center Dr",
            "address_purpose": "LOCATION",
            "city": "Lebanon",
            "state": "NH",
            "postal_code": "037561000",
            "country_code": "US",
            "telephone_number": "603-650-8622",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SLAVICH",
        "first_name": "JEFFREY",
        "credential": "P.A.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-09",
        "last_updated": "2025-12-11",
        "certification_date": "2025-12-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "ID",
            "license": "PA-2608",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02808886",
            "state": "NY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6704808",
            "state": "VT"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3124453",
            "state": "NH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Pocatello, ID

Sources for this page

Verify at the official NPI Registry.