Individual provider Active NPI

Jacqueline Barajas, PA-C

  • Physician Assistant
  • Boise, ID
National Provider Identifier
1821697590
Registry record updated Apr 26, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA-2751 Issued in ID
Practice address
701 E Parkcenter Blvd
Boise, ID 83706-6528
Phone
(208) 381-6500
Fax
(208) 381-6505
NPI assigned
Oct 22, 2020
Last updated
Apr 26, 2024By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 26, 2024

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA2022-0084
Physician Assistant 363A00000X PA2022-0084 NM
Medical Physician Assistant 363AM0700X PA2022-084 NM
Physician Assistant 363A00000X PA-2751 ID Primary

Addresses

Primary practice location

701 E Parkcenter Blvd
Boise, ID 83706-6528

Mailing address

190 E Bannock St
Boise, ID 83712-6241

Other practice location 1

2211 Lomas Blvd NE
Albuquerque, NM 87106-2719
Phone (505) 272-2411

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NM, 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
I20221108003606 NM Practitioner - Physician Assistant 7416324132 Reassigns benefits to 2 organizations
I20240614002794 ID Practitioner - Physician Assistant 7416324132 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
St Lukes Clinic-Treasure Valley LLCGroup PAC ID 4981878402, 1,155 clinicians

Practice addresses (Care Compare)

1210 NW 16TH St
Fruitland, ID 83619-2202
Phone (208) 452-8600

608 W Hays St
Boise, ID 83702-5511
Phone (208) 381-5970

610 W Hays St
Boise, ID 83702-5511
Phone (208) 381-5970

9580 W St Lukes Dr
Nampa, ID 83687-7912
Phone (208) 505-2711

9850 St Lukes Dr
Nampa, ID 83687-7912

9850 W St Luke's Dr
Nampa, ID 83687-7912

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
89.64 of 100Reported as group
Quality
75.49
Promoting interoperability
100
Improvement activities
40
Cost
76.92

Merit-based Incentive Payment System (MIPS)

Final score
87.3 of 100Reported as group
Quality
81.29
Promoting interoperability
100
Improvement activities
40
Cost
76.37

Merit-based Incentive Payment System (MIPS)

Final score
91.83 of 100Reported as group
Quality
83.58
Promoting interoperability
100
Improvement activities
40
Cost
72.52

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PA-2751IDMDPhysician Assistant
PA2022-084NMMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
St Lukes Clinic-Treasure Valley LLC CurrentSince May 4, 2024 Accepting new patients
St Lukes Clinic-Treasure Valley LLC CurrentSince May 4, 2024 Accepting new patients
Unm Medical Group, Inc. CurrentSince Sep 23, 2022 Accepting new patients
Unm Hospital CurrentSince Sep 23, 2022 Accepting new patients
Unm Hospital Physician Assistant CurrentSince Sep 23, 2022 Accepting new patients
Unm Medical Group Inc CurrentSince Sep 23, 2022 Accepting new patients
St Lukes Regional Medical Center Past Accepting new patients

Locations

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

610 W Hays St
Boise, ID 83702
Phone (208) 345-3530

701 E Parkcenter Blvd
Boise, ID 83706
Phone (208) 381-6400

3101 E State St
Ste 1100
Eagle, ID 83616
Phone (208) 473-3500

1210 NW 16th St
Fruitland, ID 83619
Phone (208) 452-8600

840 N 4th E
Mountain Home, ID 83647
Phone (208) 587-1850

400 Tijeras Ave NW
Ste 450
Albuquerque, NM 87102
Phone (505) 272-0148

2211 Lomas Blvd NE
Unm, NM 87106
Phone (505) 272-1111

Organizations & group practices 7

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 3

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": "1603324800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1714089600000",
    "number": "1821697590",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "190 E BANNOCK ST",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837126241"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "701 E PARKCENTER BLVD",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837066528",
            "telephone_number": "208-381-6500",
            "fax_number": "208-381-6505"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2211 Lomas Blvd NE",
            "address_purpose": "LOCATION",
            "city": "Albuquerque",
            "state": "NM",
            "postal_code": "871062719",
            "country_code": "US",
            "telephone_number": "505-272-2411",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BARAJAS",
        "first_name": "JACQUELINE",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-10-22",
        "last_updated": "2024-04-26",
        "certification_date": "2024-04-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": "PA2022-0084",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NM",
            "license": "PA2022-0084",
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "NM",
            "license": "PA2022-084",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "ID",
            "license": "PA-2751",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boise, ID

Sources for this page

Verify at the official NPI Registry.