Individual provider Active NPI

Jeffrey A Hansen, M.D.

  • Family Medicine Physician
  • Nampa, ID
National Provider Identifier
1932199981
Registry record updated Dec 28, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
M5246 Issued in ID
Practice address
12187 Deer Flat Rd
Nampa, ID 83686-9119
Phone
(208) 880-0576
NPI assigned
Oct 21, 2005
Last updated
Dec 28, 2023By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 28, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X M5246 ID Primary

Addresses

Primary practice location

12187 Deer Flat Rd
Nampa, ID 83686-9119

Mailing address

215 E Hawaii Ave
Nampa, ID 83686-6011
Phone (208) 463-3000

Other identifiers 5

IdentifierTypeStateIssuer
52464OtherIDBLUE CROSS
806359900OtherIDHEALTHY CONNECTIONS
080036990OtherIDRAILROAD MEDICARE
002364400MedicaidID
000010004475OtherIDBLUE SHIELD

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100315000869 ID Practitioner - Family Practice 2163528324 Practice locations: Nampa, ID

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
M5246IDMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Saltzer Medical Group, PA Family Medicine Current Accepting new patients

Locations

520 S Eagle Rd
Ste 2116
Meridian, ID 83642
Phone (208) 884-2999

215 E Hawaii Ave
Nampa, ID 83686
Phone (208) 463-3234

217 W Georgia Ave
Ste 115
Nampa, ID 83686
Phone (208) 463-3234

4403 E Flamingo Ave
Nampa, ID 83687
Phone (208) 288-4960

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/ADHBAA

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1129852800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1703721600000",
    "number": "1932199981",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "215 E HAWAII AVE",
            "city": "NAMPA",
            "state": "ID",
            "postal_code": "836866011",
            "telephone_number": "208-463-3000",
            "fax_number": "208-463-3079"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12187 DEER FLAT RD",
            "city": "NAMPA",
            "state": "ID",
            "postal_code": "836869119",
            "telephone_number": "208-880-0576"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HANSEN",
        "first_name": "JEFFREY",
        "middle_name": "A",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-10-21",
        "last_updated": "2023-12-28",
        "certification_date": "2023-12-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "ID",
            "license": "M5246",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "52464",
            "state": "ID"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTHY CONNECTIONS",
            "identifier": "806359900",
            "state": "ID"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "080036990",
            "state": "ID"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "002364400",
            "state": "ID"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD",
            "identifier": "000010004475",
            "state": "ID"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Nampa, ID

Sources for this page

Verify at the official NPI Registry.