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JAY PHAN
NPI 1669299152
Nurse Practitioner - Family in Twin Falls, ID

Active since September 25, 2024PECOS EnrolledAccepts Medicare Assignment
419 SHOUP AVE W, TWIN FALLS, ID 83301(209) 996-1700 Get Directions Write a Review

NPPES record last updated: September 25, 2024. Verified against the NPPES registry weekly; last sync: November 01, 2026.

About Jay Phan NPPES

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

JAY PHAN (NPI 1669299152) is an individual family provider in Twin Falls, Idaho, licensed in Idaho (3561779) and active in the NPI registry since September 2024. He is enrolled in Medicare PECOS and is a graduate of Other (2024).

NPPES Registry Identity

NPI1669299152
Entity TypeIndividualMale
Primary Taxonomy363LF0000X
Provider Legal NameJAY PHAN
Location Address419 SHOUP AVE WTwin Falls, ID 83301-5028
Mailing Address604 Lynwood BlvdTwin Falls, ID 83301-4133
Phone(209) 996-1700
Sole ProprietorYes
Medical School CMSOtherGraduated 2024
Enumeration DateSeptember 25, 2024
NPPES CertifiedSeptember 25, 2024
✔ NPI 1669299152 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · FamilyPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LF0000X
License✔ Licensed in ID · 3561779
419 SHOUP AVE W, Twin Falls, ID 83301
Open in Google Maps ↗

Accepted Insurance

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

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Jay Phan 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 ID6709314453
PECOS Enrollment IDI20250109001344
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.

Medicare Billing Reassignments

2

Medicare enrollment records show Jay Phan reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Associates In Family Practice Inc
28 mi
Family Medicine
425 IDAHO ST
Gooding, ID 83330
  • Reassigned Medicare billing, Idaho enrollment
  • Also billed through NPI 1326002650 (Idaho)
  • 12 clinicians in this Medicare group
NPI 1023030848 (208) 934-5900
Mental Wellness And Relationship Services LLC
372 mi
Marriage & Family Therapist
1110 W PARK PL STE 303
Coeur D Alene, ID 83814
  • Reassigned Medicare billing, Idaho enrollment
  • 9 clinicians in this Medicare group
NPI 1932773363 (208) 283-8440

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 83301 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
$93.26 typical visit price
range $16.68 – $130.93
Typical copayment $23.31 (range $4.17 – $32.73)
Most-billed visit code 99214
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 3

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

AKINS CLINIC PLLC
Nurse Practitioner (Psychiatric/Mental Health)
419 SHOUP AVE W
TWIN FALLS, ID 83301
Twin Falls County (208) 991-9323
MRS. RACHEL JOLOVICH LPC
Counselor (Professional)
419 SHOUP AVE W
TWIN FALLS, ID 83301
Twin Falls County (208) 736-0695
LINDSAY ASHMEAD LPC
Counselor
419 SHOUP AVE W
TWIN FALLS, ID 83301
Twin Falls County (208) 736-0695

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 Jay Phan's NPI number?

The NPI number for Jay Phan is 1669299152. It was assigned to this individual provider in the NPPES registry on September 25, 2024.

Where is Jay Phan located?

Jay Phan practices at 419 Shoup Ave W, Twin Falls, ID 83301. The listed phone number is (209) 996-1700.

What is Jay Phan's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.

Is Jay Phan enrolled in Medicare?

Yes. Jay Phan 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.

Which organizations bill Medicare for Jay Phan's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Jay Phan reassigns Medicare benefits to 2 organizations: Associates In Family Practice Inc (Gooding, ID) and Mental Wellness And Relationship Services LLC (Coeur D Alene, ID). Each reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Jay Phan's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Jay Phan accept?

Health plans from Moda Health Plan, Inc., Molina Healthcare, PacificSource Health Plans, Providence Health Plan and Select Health list Jay Phan 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.

When was this NPI record last updated?

The NPPES record for Jay Phan was last updated on September 25, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 years 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.