Jason Bill Gundersen, MD

Primary specialty

Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X

License

M-12486 Issued in ID

Practice address

3450 Potomac Way
Idaho Falls, ID 83404-4970

Phone

(208) 557-2900

Fax

(208) 557-2910

NPI assigned

Jun 25, 2010

Last updated

Apr 13, 2015By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

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: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Obstetrics/Gynecology

Education

Wisconsin College of Physicians and Surgeons, 2010

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Women's Healthcare Associates, P.a.Group PAC ID 3577540616, 15 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Mountain View Hospital Hospital, Idaho Falls, ID, CCN 130065

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

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.

• Women's Healthcare Associates, P.a.

  dba Rosemark WomenCare Specialists and/or Margaret Huggins, MD

  • Obstetrics & Gynecology Physician
  • Idaho Falls, ID
  • NPI 1255400636
  Medicare reassignment Care Compare group NPD
• Angel Wings Center of Healing

  • Clinical Social Worker
  • Idaho Falls, ID
  • NPI 1215159819
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Mountain View Hospital LLC

  • General Acute Care Hospital
  • Idaho Falls, ID
  • NPI 1669462362
  Care Compare affiliation

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1277424000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1428883200000",
    "number": "1841501731",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3450 POTOMAC WAY",
            "city": "IDAHO FALLS",
            "state": "ID",
            "postal_code": "834044970",
            "telephone_number": "208-557-2900",
            "fax_number": "208-557-2910"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3450 POTOMAC WAY",
            "city": "IDAHO FALLS",
            "state": "ID",
            "postal_code": "834044970",
            "telephone_number": "208-557-2900",
            "fax_number": "208-557-2910"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GUNDERSEN",
        "first_name": "JASON",
        "middle_name": "BILL",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-06-25",
        "last_updated": "2015-04-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "ID",
            "license": "M-12486",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1841501731",
            "state": "ID"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Guy Eric Grooms, MD
• Riley Alen Grube, DPT, PT
• Eliseo Guerra
• Solange Guerrero Rodriguez, BA
• Magali Guerrero
• Kenneth James Gunderson, FNP-C
• Jamie Kae Gunerud, OTR/L
• Jennifer Anne Gunter, PHARMD
• Ritika Gupta
• Antonia Gutierrez Benitez, LPC

• Obstetrics & Gynecology Physician in Idaho Falls, ID
• Providers in Idaho Falls, ID by specialty
• Obstetrics & Gynecology Physician in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 13, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.