Individual provider Active NPI

Jessica Lynn Kroll, M.D.

  • Emergency Medicine Physician
  • Boise, ID
National Provider Identifier
1861798548
Registry record updated Jul 24, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
M-14063 Issued in ID
Practice address
6051 W Emerald St
Boise, ID 83704-8969
Phone
(208) 302-5150
Fax
(208) 302-5155
NPI assigned
Jan 28, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 24, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X R73922 AZ
Student in an Organized Health Care Education/Training Program 390200000X
Emergency Medicine Physician 207P00000X M-14063 ID Primary

Addresses

Primary practice location

6051 W Emerald St
Boise, ID 83704-8969

Mailing address

6051 W Emerald St
Boise, ID 83704-8969
Phone (208) 302-5150

Other practice location 1

1501 N Campbell Ave
Tucson, AZ 85724-0001
Phone (520) 626-7233

Other names 1

  • Jessica Lynn Prior Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ID, OR2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20180321002168 ID Practitioner - Emergency Medicine 3173819679 Reassigns benefits to 3 organizations
I20180719001326 OR Practitioner - Emergency Medicine 3173819679 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
University of California, Davis School of Medicine, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Saint Alphonsus Regional Medical Center IncGroup PAC ID 3476462359, 672 clinicians

Practice addresses (Care Compare)

10583 W Lake Hazel Rd
Boise, ID 83709-6326
Phone (208) 302-5900

10717 W State St
Star, ID 83669-6046
Phone (208) 302-6300

1150 N Sister Catherine Way
Nampa, ID 83687-3133
Phone (208) 302-7000

3025 W Cherry LN
Meridian, ID 83642-8531

6022 W Emerald St
Boise, ID 83704-8855
Phone (208) 367-4603

6094 W Emerald St
Boise, ID 83704-8855
Phone (208) 302-1000

867 S Vanguard Way
Meridian, ID 83642-7552
Phone (208) 302-7950

Hospital & facility affiliations

  • Saint Alphonsus Regional Medical Center Hospital, Boise, ID, CCN 130007

Merit-based Incentive Payment System (MIPS)

Final score
87.3 of 100Reported as group
Quality
70.94
Improvement activities
40
Cost
92.94

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
R73922AZMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Saint Alphonsus Regional Medical Center Inc CurrentSince Sep 1, 2024 Accepting new patients
Cep America LLC Emergency Medicine CurrentSince Jul 1, 2018 Accepting new patients
Saint Alphonsus Medical Center- Ontario Inc CurrentSince Nov 28, 2024 Accepting new patients
Saint Alphonsus Regional Medical Center Inc Current Accepting new patients
Cep America, LLC Emergency Medicine CurrentSince Apr 1, 2018 Accepting new patients
Saint Alphonsus Regional Medical Center Inc CurrentSince Sep 1, 2024 Accepting new patients
Cep America, LLC Emergency Medicine Current Accepting new patients
Cep America LLC Emergency Medicine CurrentSince Apr 1, 2018 Accepting new patients
Saint Alphonsus Medical Center- Ontario Inc CurrentSince Nov 28, 2024 Accepting new patients

Locations

2100 Powell St
Ste 900
Emeryville, CA 94608
Phone (510) 350-2777

1601 Cummins Dr
Ste D
Modesto, CA 95358
Phone (510) 851-7423

1055 N Curtis Rd
Boise, ID 83706
Phone (208) 367-2152

6051 W Emerald St
Boise, ID 83704
Phone (208) 302-5100

910 NW 16th St
Ste 101
Fruitland, ID 83619
Phone (208) 452-8000

3025 W Cherry Ln
Ste B
Meridian, ID 83642
Phone (208) 302-6400

351 SW 9th St
Ontario, OR 97914
Phone (541) 881-7000

2700 NW Stewart Pkwy
Roseburg, OR 97471
Phone (541) 673-0611

Interoperability endpoints

  • Direct secure messaging: jkroll1563889@direct.trinity-health.org

Organizations & group practices 9

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 5

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": "1296172800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721779200000",
    "number": "1861798548",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6051 W EMERALD ST",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837048969",
            "telephone_number": "208-302-5150"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6051 W EMERALD ST",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837048969",
            "telephone_number": "208-302-5150",
            "fax_number": "208-302-5155"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1501 N Campbell Ave",
            "address_purpose": "LOCATION",
            "city": "Tucson",
            "state": "AZ",
            "postal_code": "857240001",
            "country_code": "US",
            "telephone_number": "520-626-7233",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KROLL",
        "first_name": "JESSICA",
        "middle_name": "LYNN",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-01-28",
        "last_updated": "2024-07-24",
        "certification_date": "2024-07-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "AZ",
            "license": "R73922",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "ID",
            "license": "M-14063",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JESSICA",
            "last_name": "PRIOR",
            "middle_name": "LYNN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Boise, ID

Sources for this page

Verify at the official NPI Registry.