NPIMap

Individual provider Active NPI

Jason E Kolb, PA-C

  • Physician Assistant
  • Boise, ID
National Provider Identifier
1992215545
Registry record updated Jan 25, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA-1545 Issued in ID
Practice address
1075 N Curtis Rd
Ste 201
Boise, ID 83706
Phone
(208) 302-3300
Fax
(208) 302-3355
NPI assigned
Oct 10, 2017
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 25, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA202158 OR
Physician Assistant 363A00000X PA-1545 ID Primary

Addresses

Primary practice location

1075 N Curtis Rd
Ste 201
Boise, ID 83706

Mailing address

3340 E Goldstone Dr
Meridian, ID 83642
Phone (208) 302-3300

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ID, OR2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20171114003303 ID Practitioner - Physician Assistant 4486910031 Reassigns benefits to 1 organization
I20210211003184 OR Practitioner - Physician Assistant 4486910031 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Saint Alphonsus Regional Medical Center Inc 672 clinicians

Practice addresses (Care Compare)

1050 SW 3Rd Ave
Suite 2600
Ontario, OR 97914-4557
Phone (208) 302-2000

1050 SW 3Rd Ave
Suite 3200
Ontario, OR 97914-4560
Phone (541) 881-7000

3025 W Cherry LN
Meridian, ID 83642-8530

3025 W Cherry LN
Meridian, ID 83642-8531

3175 Pocahontas Rd
Baker City, OR 97814-1434
Phone (208) 302-2200

4400 E Flamingo Ave
Nampa, ID 83687-9203

4402 E Flamingo Ave
Nampa, ID 83687-9203
Phone (208) 288-4520

Hospital & facility affiliations

  • Saint Alphonsus Regional Medical Center Hospital, Boise, ID, CCN 130007
  • Saint Alphonsus Medical Center - Nampa Hospital, Nampa, ID, CCN 130013
  • Saint Alphonsus Medical Center Ontario Hospital, Ontario, OR, CCN 380052

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PA-1545IDMDPhysician Assistant
PA202158ORMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Saint Alphonsus Regional Medical Center Inc CurrentSince Sep 1, 2019 Accepting new patients
Saint Alphonsus Regional Medical Center Inc Physician Assistant CurrentSince Sep 1, 2019 Accepting new patients
Saint Alphonsus Specialty Services Inc PastSince Aug 6, 2019 Accepting new patients

Locations

1075 N Curtis Rd
Ste 201
Boise, ID 83706
Phone (208) 302-3300

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

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

3340 E Goldstone Dr
Meridian, ID 83642
Phone (208) 302-9342

3175 Pocahontas Rd
Baker City, OR 97814
Phone (208) 302-2200

Interoperability endpoints

  • Direct secure messaging: jkolb1563985@direct.trinity-health.org
  • Direct secure messaging: jason.kolb@phmg.eclinicaldirectplus.com

Organizations & group practices 6

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 7

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": "1507593600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1611532800000",
    "number": "1992215545",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3340 E GOLDSTONE DR",
            "city": "MERIDIAN",
            "state": "ID",
            "postal_code": "83642",
            "telephone_number": "208-302-3300",
            "fax_number": "208-302-3355"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1075 N CURTIS RD",
            "address_2": "STE 201",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "83706",
            "telephone_number": "208-302-3300",
            "fax_number": "208-302-3355"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOLB",
        "first_name": "JASON",
        "middle_name": "E",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2017-10-10",
        "last_updated": "2021-01-25",
        "certification_date": "2021-01-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "OR",
            "license": "PA202158",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "ID",
            "license": "PA-1545",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boise, ID

Sources for this page

Verify at the official NPI Registry.