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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: July 19, 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
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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.

Areas of Expertise CMS Part B claims

Services this provider delivered to Medicare fee-for-service patients, from the 2024 & 2026 CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Established patient office or other outpatient visit, 10-19 minutes 99212
This is a routine check-up for patients who have previously seen the doctor. During this 10-19 minute visit, the doctor will review your health status, discuss any concerns, and manage ongoing treatments or medications. It's a chance to ensure your health is on track.
17 services14 patients

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.

LESLIE JEAN MCGOVERN PA-C, MHE, ATC, LAT
Physician Assistant (Medical)
777 HOSPITAL WAY
POCATELLO, ID 83201
Bannock County (480) 421-9700
CDS,PA
Obstetrics & Gynecology
777 HOSPITAL WAY, BLDG A, STE 300
POCATELLO, ID 83201
Bannock County (208) 232-6100
TAMMY L SKIDMORE CRNA
Nurse Anesthetist, Certified Registered
777 HOSPITAL WAY
POCATELLO, ID 83201
Bannock County (208) 239-1000
DR. KIM LEON COX MD
Obstetrics & Gynecology
777 HOSPITAL WAY, BLDG A SUITE 300
POCATELLO, ID 83201
Bannock County (208) 232-8792
ALEX J BRINGHURST CRNA
Nurse Anesthetist, Certified Registered
777 HOSPITAL WAY
POCATELLO, ID 83201
Bannock County (208) 239-1000
DR. DANIEL DALLEY SNELL M.D, M.P.H.
Anesthesiology
777 HOSPITAL WAY
POCATELLO, ID 83201
Bannock County (208) 232-7760
ROCKY MOUNTAIN EMERGENCY PHYSICIANS, LLC
Emergency Medicine (Emergency Medical Services)
777 HOSPITAL WAY
POCATELLO, ID 83201
Bannock County (480) 421-9799
IHC HEALTH SERVICES INC
Clinic/Center (Multi-Specialty)
777 HOSPITAL WAY
POCATELLO, ID 83201
Bannock County (801) 507-3500

Frequently Asked Questions

What is Jared Wilson's NPI number?

The NPI number assigned to this healthcare provider is 1275748089, enumerated as an "individual" on May 14, 2007.

Where is the provider located?

The provider is located at 777 HOSPITAL WAY SOUTH MOB, SUITE 204 POCATELLO, ID 83201 and the phone number is (208) 239-2110.

What is the provider's specialty?

Physician Assistant with taxonomy code 363AS0400X and a focus in Surgical.

What insurance does Jared Wilson accept?

The provider might be accepting Accepts: Moda Health Plan, Inc., PacificSource Health. Please consult your insurance carrier or call the provider to verify.

Is Jared Wilson affiliated with any hospitals?

Jared Wilson is affiliated with: PORTNEUF MEDICAL CENTER.