1. Home
  2. Directory
  3. Idaho
  4. Falls
  5. Physician Assistant
  6. NPI Profile

ALYSSA MAY JACK PA-C
NPI 1598357436
Physician Assistant in Idaho Falls, ID

Active since February 10, 2021PECOS EnrolledAccepts Medicare Assignment
535 W SUNNYSIDE RD STE 2, IDAHO FALLS, ID 83402(208) 357-9700(208) 963-3245 Get Directions Write a Review

NPPES record last updated: June 17, 2025. Verified against the NPPES registry weekly; last sync: August 16, 2026.

Record update history: Jun 17, 2025, Dec 16, 2024, Feb 10, 2021 (3 updates tracked since 2021).

About Alyssa May Jack Pa-c NPPES

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

ALYSSA MAY JACK PA-C (NPI 1598357436) is an individual physician assistant in Idaho Falls, Idaho, licensed in Idaho (PA-1966) and active in the NPI registry since February 2021. She is enrolled in Medicare PECOS, is affiliated with Madison Memorial Hospital, and is a graduate of Other (2020).

NPPES Registry Identity

NPI1598357436
Entity TypeIndividualFemale
Primary Taxonomy363A00000X
Provider Legal NameALYSSA MAY JACKCredential: PA-C
Location Address535 W SUNNYSIDE RD STE 2Idaho Falls, ID 83402-4647
Mailing Address4095 E Menan Lorenzo HwyRigby, ID 83442-5169 · (208) 847-5762 · Fax (208) 963-3245
Phone(208) 357-9700
Fax(208) 963-3245
Sole ProprietorNo
Medical School CMSOtherGraduated 2020
Enumeration DateFebruary 10, 2021
Last NPPES UpdateJune 17, 20253 updates tracked since enumeration
NPPES CertifiedJune 17, 2025
✔ NPI 1598357436 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPhysician AssistantPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363A00000X
License✔ Licensed in ID · PA-1966
Definition
A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician.
535 W SUNNYSIDE RD STE 2, Idaho Falls, ID 83402
Open in Google Maps ↗

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Moda Health Plan, Inc..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

Alyssa May Jack Pa-c 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 ID244646578
PECOS Enrollment IDI20210310001827
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 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 with high level of medical decision making, if using time, 40 minutes or more 99215
This service involves a follow-up appointment for existing patients, lasting between 40 to 54 minutes. During this time, your healthcare provider will assess your current health status, discuss any changes or concerns, review your treatment plan, and answer any questions you may have.
17 services11 patients

Hospital Affiliations CMS Care Compare

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

Madison Memorial Hospital

Acute Care Hospitals · Rexburg, ID
5/5 CMS rating
OwnershipGovernment - Local
CMS Certification Number130025
Location450 East Main StreetRexburg, ID 83440 · Madison County
Emergency services

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 83402 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$81.13 typical visit price
range $52.44 – $160.17
Typical copayment $20.28 (range $13.11 – $40.04)
Most-billed visit code 99203
Established Patient
$65.77 typical visit price
range $16.68 – $130.93
Typical copayment $16.44 (range $4.17 – $32.73)
Most-billed visit code 99213
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 4

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

GUY ERIC GROOMS MD
Orthopaedic Surgery
535 W SUNNYSIDE RD STE 2
IDAHO FALLS, ID 83402
Bonneville County (208) 357-9700
HELIX MEDICAL LLC
Internal Medicine (Rheumatology)
535 W SUNNYSIDE RD STE 2
IDAHO FALLS, ID 83402
Bonneville County (208) 291-1208
ROCKY MOUNTAIN MEDICAL LLC
Orthopaedic Surgery
535 W SUNNYSIDE RD STE 2
IDAHO FALLS, ID 83402
Bonneville County (208) 357-9700
ROCKY MOUNTAIN MEDICAL LLC
Internal Medicine
535 W SUNNYSIDE RD STE 2
IDAHO FALLS, ID 83402
Bonneville County (208) 330-3007

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 Alyssa Jack's NPI number?

The NPI number for Alyssa Jack is 1598357436. It was assigned to this individual provider in the NPPES registry on February 10, 2021.

Where is Alyssa Jack located?

Alyssa Jack practices at 535 W Sunnyside Rd Ste 2, Idaho Falls, ID 83402. The listed phone number is (208) 357-9700.

What is Alyssa Jack's specialty?

The primary specialty registered for this NPI is Physician Assistant with taxonomy code 363A00000X.

Is Alyssa Jack enrolled in Medicare?

Yes. Alyssa Jack 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 Alyssa Jack accept?

Health plans from Moda Health Plan, Inc. list Alyssa Jack 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 Alyssa Jack affiliated with any hospitals?

According to CMS data, Alyssa Jack is affiliated with Madison Memorial Hospital.

When was this NPI record last updated?

The NPPES record for Alyssa Jack was last updated on June 17, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 14 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.