Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Derrick Ray Jorgensen

Individual provider Physician Assistant · NPI 1609519198

Derrick Ray Jorgensen is a Physician Assistant in Idaho Falls, Idaho. Qualified in 2021, 5 years ago. Practices with Steele Lake Specialty PLLC, a 19-clinician group and accepts Medicare assignment. Licensed in Idaho.

Years since qualifying
5
Licensed in
ID
In the registry since
2022

Practice location Address checks out

3200 Channing Way Ste A206
Idaho Falls, ID 83404-7586
Phone: (208) 529-2230
Fax: (208) 561-8061
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence PA-2250 (ID)

Record details

NPI number1609519198
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorNo
NPI enumeratedApril 14, 2022
Last updated in NPPESJune 9, 2026
Certification dateJune 9, 2026

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2021 (5 years in practice)
Group practice Steele Lake Specialty Pllc — 19 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

Other providers in Idaho Falls