GEM STATE DERMATOLOGY, PA
NPI 1912040270
Dermatology in Boise, ID
- Organization
- Dermatology
- Accepts Insurance
- CLIA Number: 13D0935092
- CLIA Cert. Type: Practitioner Other
- CLIA Exp. Date: 05-03-2026
About GEM STATE DERMATOLOGY, PA
This page provides the complete NPI Profile along with additional information for Gem State Dermatology, Pa, a provider established in Boise, Idaho operating as a Dermatology. The healthcare provider is registered in the NPI registry with number 1912040270 assigned on February 2007. The practitioner's primary taxonomy code is 207N00000X with license number M7247 (ID). The provider is registered as an organization and their NPI record was last updated 12 years ago. The authorized official of this NPI record is Ms. Michelle Morgan (Practice Manager)
- NPI
- 1912040270 Verify this NPI
- Provider Name
- GEM STATE DERMATOLOGY, PA
- Entity Type
- Organization
- Location Address
- 388 E. PARKCENTER BLVD. BOISE, ID 83706
- Location Phone
- (208) 424-9101
- Location Fax
- (208) 424-5072
- Mailing Address
- PO BOX 1603 BOISE, ID 83702
- Mailing Phone
- (208) 424-9101
- Mailing Fax
- (208) 424-5072
- Is Sole Proprietor?
- No
- Is Organization Subpart?
- No
- Enumeration Date
- 02-15-2007
- Last Update Date
- 12-02-2014
- Code Navigator
A dermatologist like Gem State Dermatology, Pa is a medical specialty involving the management of skin conditions and diseases. Dermatologists diagnose some sexually transmitted diseases, warts, cancer, acne, dermatitis and may offer cosmetic treatments, and therapies that reduce age spots and wrinkles.
Location Map
Specialty - Primary Taxonomy
The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
- Classification
Dermatology
- Taxonomy Code
- 207N00000X
- Type
- Allopathic & Osteopathic Physicians
- License No.
- M7247
- License State
- ID
- Taxonomy Description
- 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.
Secondary Taxonomies
The provider has reported to the NPI enumerator additional taxonomy codes. Multiple taxonomy codes may represent subspecialties or other areas of specialization the provider maybe licensed to practice.
| No. | Taxonomy Code | Type | Classification / Specialization |
License No. (State) |
|---|---|---|---|---|
| 1 | 261QM2500X | Ambulatory Health Care Facilities | Clinic/Center | M7247 (ID) |
| 2 | 363A00000X | Physician Assistants & Advanced Practice Nursing Providers | Physician Assistant | PA377 (ID) |
Insurance Plans Accepted
According to publicly available information the provider might be accepting the following health plans from these health insurance companies:
- Moda Health Affinity Bronze 8000 - EPO
- Moda Health Affinity Bronze 9000 - EPO
- Moda Health Affinity Bronze HDHP 7500 - EPO
- Moda Health Affinity Gold 1000 - EPO
- Moda Health Affinity Gold 1500 - EPO
- Moda Health Affinity Gold 250 - EPO
- Moda Health Affinity Silver 3000 - EPO
- Moda Health Affinity Silver 3400 - EPO
- Moda Health Affinity Silver 4500 - EPO
- Moda Health Affinity Silver 6000 - EPO
- Moda Health Oregon Standard Bronze Affinity - EPO
- Moda Health Oregon Standard Gold Affinity - EPO
- Moda Health Oregon Standard Silver Affinity - EPO
- Moda Select Alaska Bronze 6500 - PPO
- Moda Select Alaska Bronze HDHP 5500 - PPO
- Moda Select Alaska Gold 1500 - PPO
- Moda Select Alaska Silver 4500 - PPO
- Moda Select Alaska Standard Bronze - PPO
- Moda Select Alaska Standard Gold - PPO
- Moda Select Alaska Standard Silver - PPO
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
*Please verify directly with this provider to make sure your insurance plan is currently accepted.
Additional Identifiers
The NPI Enumerator encourages providers to submit additional identifiers with their NPI application although the submission of this information is optional. The additional identifier(s) section includes other numbers or codes currently or formerly used as an identifier for the provider by other public healthcare entities. The identifiers may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.
| Identifier | Type / Code | Identifier State | Identifier Issuer |
|---|---|---|---|
| 1375651 | MEDICARE ID-TYPE UNSPECIFIED (04) | ID | |
| 805054600 | MEDICAID (05) | ID | |
| G56246 | MEDICARE UPIN (02) | ID |
CLIA Information
The Clinical Laboratory Improvement Amendments (CLIA) of 1988 applies to facilities or sites that test human specimens for health assessment or to diagnose, prevent, or treat disease. The CLIA Program sets standards for clinical laboratory testing and issues certificates. The NPI / CLIA crosswalk information for this NPI number is:
- CLIA Number
- 13D0935092
- Facility Type
- Practitioner Other
- Certificate Effective Date
- May 04, 2024
- Certificate Expiration Date
- May 03, 2026
- Laboratory Director
- STEVEN M. MINGS
- Certificate Type
- Certificate of Compliance
- Certificate Type Description
- This CLIA certificate is issued to Gem State Dermatology, Pa after an inspection that finds the laboratory to be in compliance with all applicable CLIA requirements. This type of certificate is issued to laboratories that perform nonwaived (moderate and/or high complexity) testing.
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Other Providers at the Same Location
The following 2 providers are registered at the same or a nearby location.
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1912040270, enumerated as an "organization" on February 15, 2007.
The provider is located at 388 E. PARKCENTER BLVD. BOISE, ID 83706 and the phone number is (208) 424-9101.
Dermatology with taxonomy code 207N00000X.
The provider might be accepting Accepts: Moda Health Plan, Inc., Medicare and Medicaid. Please consult your insurance carrier or call the provider to verify.
