GEM STATE DERMATOLOGY, PA
NPI 1912040270
Dermatology in Boise, ID

Active since February 15, 2007
388 E. PARKCENTER BLVD., BOISE, ID 83706(208) 424-9101(208) 424-5072 Get Directions Write a Review

NPPES record last updated: December 2, 2014. Verified against the NPPES registry weekly; last sync: October 18, 2026.

About Gem State Dermatology, Pa NPPES

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

GEM STATE DERMATOLOGY, PA (NPI 1912040270) is a healthcare organization registered as a dermatology in Boise, Idaho and active in the NPI registry since February 2007. The organization lists Michelle Morgan, Practice Manager, as its authorized official.

NPPES Registry Identity

NPI1912040270
Entity TypeOrganization
Primary Taxonomy207N00000X
Legal Business NameGEM STATE DERMATOLOGY, PA
Location Address388 E. PARKCENTER BLVD.Boise, ID 83706
Mailing AddressPo Box 1603Boise, ID 83702-1603 · (208) 424-9101 · Fax (208) 424-5072
Fax(208) 424-5072
Organization SubpartNo
Authorized OfficialMichelle MorganPractice Manager · (208) 424-9101
Enumeration DateFebruary 15, 2007
Last NPPES UpdateDecember 2, 2014
✔ NPI 1912040270 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

★ Primary SpecialtyDermatologyAllopathic & Osteopathic Physicians
Taxonomy Code207N00000X
License✔ Licensed in ID · M7247
Definition
A dermatologist is trained to diagnose and treat pediatric and adult patients with benign and malignant disorders of the skin, mouth, external genitalia, hair and nails, as well as a number of sexually transmitted diseases. The dermatologist has had additional training and experience in the diagnosis and treatment of skin cancers, melanomas, moles and other tumors of the skin, the management of contact dermatitis and other allergic and nonallergic skin disorders, and in the recognition of the skin manifestations of systemic (including internal malignancy) and infectious diseases. Dermatologists have special training in dermatopathology and in the surgical techniques used in dermatology. They also have expertise in the management of cosmetic disorders of the skin such as hair loss and scars and the skin changes associated with aging.
Also ListedClinic/Center · Medical SpecialtyTaxonomy 261QM2500X · License M7247 (ID)
Also ListedPhysician AssistantTaxonomy 363A00000X · License PA377 (ID)
388 E. PARKCENTER BLVD., Boise, ID 83706

Other Identifiers 3

Medicare ID-Type Unspecified1375651ID
Medicaid805054600ID
Medicare UPING56246ID

Accepted Insurance

Medicare Participation & PECOS CMS

Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Gem State Dermatology, Pa is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

Medicare enrollment records show 1 clinician reassigns Medicare billing to Gem State Dermatology, PA, which bills Medicare for the services this clinician delivers.

Clinician (1)

Dermatology
NPI 1548214265
388 E. PARKCENTER BLVD.
Boise, ID 83706
(208) 424-9101
✔ PECOS✔ Accepts Medicare0.4 mi

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

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 Gem State Dermatology, PA's NPI number?

The NPI number for Gem State Dermatology, PA is 1912040270. It was assigned to this organization in the NPPES registry on February 15, 2007.

Where is Gem State Dermatology, PA located?

Gem State Dermatology, PA is located at 388 E. Parkcenter Blvd., Boise, ID 83706. The listed phone number is (208) 424-9101.

What is Gem State Dermatology, PA's specialty?

The primary specialty registered for this NPI is Dermatology with taxonomy code 207N00000X.

Is Gem State Dermatology, PA enrolled in Medicare?

Yes. Gem State Dermatology, PA is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Gem State Dermatology, PA?

According to the CMS Revalidation Reassignment List (October 2026 release), 1 clinician (Dermatology) reassigns their Medicare billing to Gem State Dermatology, PA. A 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 the clinician's services. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

What insurance does Gem State Dermatology, PA accept?

Health plans from Moda Health Plan, Inc. list Gem State Dermatology, PA 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 Gem State Dermatology, PA was last updated on December 2, 2014. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 11 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.