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JARED KENT WILSON PA-C, MPAS, MED, ATC
NPI 1275748089
Physician Assistant - Surgical in Pocatello, ID

Active since May 14, 2007PECOS EnrolledAccepts Medicare Assignment
777 HOSPITAL WAY, SOUTH MOB, SUITE 204, POCATELLO, ID 83201(208) 239-2110(208) 239-2119 Get Directions Write a Review

NPPES record last updated: August 3, 2025. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About Jared Kent Wilson Pa-c, Mpas, Med, Atc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

JARED KENT WILSON PA-C, MPAS, MED, ATC (NPI 1275748089) is an individual surgical provider in Pocatello, Idaho, licensed in Idaho (PA-952) and active in the NPI registry since May 2007. He is enrolled in Medicare PECOS, is affiliated with Portneuf Medical Center, and is a graduate of Other (2011).

NPPES Registry Identity

NPI1275748089
Entity TypeIndividualMale
Primary Taxonomy363AS0400X
Provider Legal NameJARED KENT WILSONCredential: PA-C, MPAS, MED, ATC
Location Address777 HOSPITAL WAY, SOUTH MOB, SUITE 204Pocatello, ID 83201-5175
Mailing Address777 Hospital Way, South Mob, Suite 204Pocatello, ID 83201-5175 · (208) 239-2110 · Fax (208) 239-2119
Phone(208) 239-2110
Fax(208) 239-2119
Sole ProprietorNo
Medical School CMSOtherGraduated 2011
Enumeration DateMay 14, 2007
Last NPPES UpdateAugust 3, 2025
NPPES CertifiedAugust 3, 2025
✔ NPI 1275748089 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyPhysician Assistant · SurgicalPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363AS0400X
License✔ Licensed in ID · PA-952
Also ListedSpecialist/Technologist · Athletic TrainerTaxonomy 2255A2300X · License AT-492 (ID)
777 HOSPITAL WAY, Pocatello, ID 83201
Open in Google Maps ↗

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Moda Health Plan, Inc., PacificSource Health Plans, Providence Health Plan and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Jared Kent Wilson Pa-c, Mpas, Med, Atc is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID1658548797
PECOS Enrollment IDI20120112000823
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Hospital Affiliations CMS Care Compare

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Portneuf Medical Center

Acute Care Hospitals · Pocatello, ID
4/5 CMS rating
OwnershipProprietary
CMS Certification Number130028
Location777 Hospital WayPocatello, ID 83201 · Bannock County
Emergency services Birthing friendly

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MS. EUNICE GRACE GARDNER PH.D.
Psychologist (Adult Development & Aging)
777 HOSPITAL WAY
POCATELLO, ID 83201
Bannock County (208) 239-1710
JESS LUFKIN CRNA
Nurse Anesthetist, Certified Registered
777 HOSPITAL WAY
POCATELLO, ID 83201
Bannock County (208) 716-7215
ROGER A COOK MD
Anesthesiology
777 HOSPITAL WAY
POCATELLO, ID 83201
Bannock County (208) 239-1000
JASON MONTGOMERY NP-C
Nurse Practitioner (Family)
777 HOSPITAL WAY
POCATELLO, ID 83201
Bannock County (208) 239-2580
ALYSSA M WOODBURY PA-C
Physician Assistant
777 HOSPITAL WAY
POCATELLO, ID 83201
Bannock County (208) 239-1226
SHANNON ALISON WEBB PA-C
Physician Assistant
777 HOSPITAL WAY
POCATELLO, ID 83201
Bannock County (208) 239-1000
DR. ROBERT MICHAEL KENNEDY M.D.
Psychiatry & Neurology (Neurology)
777 HOSPITAL WAY, G15
POCATELLO, ID 83201
Bannock County (208) 239-2722
MEDICAL IMAGING ASSOC OF IDAHO FALLS, PA
Physician Assistant
777 HOSPITAL WAY
POCATELLO, ID 83201
Bannock County (208) 227-2600

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Jared Wilson's NPI number?

The NPI number for Jared Wilson is 1275748089. It was assigned to this individual provider in the NPPES registry on May 14, 2007.

Where is Jared Wilson located?

Jared Wilson practices at 777 Hospital Way South Mob, Suite 204, Pocatello, ID 83201. The listed phone number is (208) 239-2110.

What is Jared Wilson's specialty?

The primary specialty registered for this NPI is Physician Assistant, specializing in Surgical, with taxonomy code 363AS0400X.

Is Jared Wilson enrolled in Medicare?

Yes. Jared Wilson is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

What insurance does Jared Wilson accept?

Health plans from Moda Health Plan, Inc., PacificSource Health Plans, Providence Health Plan and Select Health list Jared Wilson as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

Is Jared Wilson affiliated with any hospitals?

According to CMS data, Jared Wilson is affiliated with Portneuf Medical Center.

When was this NPI record last updated?

The NPPES record for Jared Wilson was last updated on August 3, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 12 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.