Individual provider Active NPI

Jill K. Zelaya, PA-C

  • Physician Assistant
  • Ketchum, ID
National Provider Identifier
1790030518
Registry record updated Jun 2, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
100 Hospital Dr.
Ketchum, ID 83340
Phone
(208) 726-5027
NPI assigned
Jul 18, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 2, 2016

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 Primary

Addresses

Primary practice location

100 Hospital Dr.
Ketchum, ID 83340

Mailing address

PO Box 100
Ketchum, ID 83340-0100
Phone (208) 726-5027

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ID
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 1

Enrollment IDStateProvider typePAC IDDetails
I20140715002566 ID Practitioner - Physician Assistant 5890949499 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
St Lukes Clinic - Wood River LLCGroup PAC ID 3173783818, 66 clinicians

Practice addresses (Care Compare)

100 Hospital Dr
Ketchum, ID 83340

100 Hospital Dr
Ketchum, ID 83340-9998

191 5TH St W
Ketchum, ID 83340-9998
Phone (208) 725-2171

Hospital & facility affiliations

National Provider Directory

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

Interoperability endpoints

  • Direct secure messaging: jzelaya20780@direct.slhs.org

Organizations & group practices 1

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 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": "1342569600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1464825600000",
    "number": "1790030518",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 100",
            "city": "KETCHUM",
            "state": "ID",
            "postal_code": "833400100",
            "telephone_number": "208-726-5027"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 HOSPITAL DR.",
            "city": "KETCHUM",
            "state": "ID",
            "postal_code": "83340",
            "telephone_number": "208-726-5027"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ZELAYA",
        "first_name": "JILL",
        "middle_name": "K.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-07-18",
        "last_updated": "2016-06-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ketchum, ID

Sources for this page

Verify at the official NPI Registry.