Jacqueline Barajas, PA-C
Individual provider Active NPI Physician Assistant · Boise, ID
NPI 1821697590 · NPPES record last updated Apr 26, 2024
Key facts
- NPI
- 1821697590
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physician Assistant 363A00000X
- License
- PA-2751 (ID)
- Practice address
- 701 E Parkcenter Blvd
Boise, ID 83706-6528 - Phone
- (208) 381-6500
- Fax
- (208) 381-6505
- NPI assigned
- Oct 22, 2020
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 8
Hospital & facility affiliations 3
Medicare Care Compare profile
- Specialty
- Physician Assistant
- Education
- Other, 2022
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- St Lukes Clinic-Treasure Valley LLC
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
- St Luke'S Nampa Medical Center
- St Luke'S Regional Medical Center
Merit-based Incentive Payment System (MIPS)
- Final score
- 89.64 of 100
- Quality
- 75.49
- Promoting interoperability
- 100
- Improvement activities
- 40
- Cost
- 76.92
Merit-based Incentive Payment System (MIPS)
- Final score
- 87.3 of 100
- Quality
- 81.29
- Promoting interoperability
- 100
- Improvement activities
- 40
- Cost
- 76.37
Merit-based Incentive Payment System (MIPS)
- Final score
- 91.83 of 100
- Quality
- 83.58
- Promoting interoperability
- 100
- Improvement activities
- 40
- Cost
- 72.52
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (2 enrollments) in NM, ID
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20221108003606 | NM | Practitioner - Physician Assistant | 7416324132 | Reassigns benefits to 2 organizations |
| I20240614002794 | ID | Practitioner - Physician Assistant | 7416324132 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PA-2751 | ID | MD | Physician Assistant |
| PA2022-0084 | NM | MD | Physician Assistant |
| PA2022-084 | NM | MD | Medical Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| St Lukes Clinic-Treasure Valley LLC | Current |
Accepting new patients | |
| Unm Hospital | Current |
Accepting new patients | |
| Unm Medical Group, Inc. | Current |
Accepting new patients | |
| St Lukes Regional Medical Center | Past | Accepting new patients |
Locations
190 E Bannock St
Boise, ID 83712
Phone (208) 381-2378
701 E Parkcenter Blvd
Boise, ID 83706
Phone (208) 381-6400
610 W Hays St
Boise, ID 83702
Phone (208) 345-3530
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
2211 Lomas Blvd NE
Unm, NM 87106
Phone (505) 272-1111
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | PA2022-0084 | ||
| Physician Assistant | 363A00000X | PA2022-0084 | NM | |
| Medical Physician Assistant | 363AM0700X | PA2022-084 | NM | |
| Physician Assistant | 363A00000X | PA-2751 | ID | Yes |
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
Other providers in Boise, ID
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 26, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.