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

Dr. Jason Baltar Rodulfa, MD

Individual provider Neuroradiology Physician · NPI 1891102620

Dr. Jason Baltar Rodulfa, MD is a Diagnostic Radiology in Coeur D Alene, Idaho. Qualified in 2014, 12 years ago. Practices with Kootenai Health Inc, a 394-clinician group, works from 2 locations and accepts Medicare assignment. Licensed in Idaho, Nevada and West Virginia.

Years since qualifying
12
Licensed in
ID, NV, WV
In the registry since
2014
Specialties on file
4
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.

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Practice location Address checks out

700 W Ironwood Dr Ste 175
Coeur D Alene, ID 83814-4401
Phone: (208) 625-6300
Fax: (208) 625-6301
Show map & directions

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

Additional practice locations (1)

  • 25 Jacobs Gulch Rd, Kellogg, ID 83837-2023 — (208) 784-1221

Specialties & licences

Diagnostic Radiology Physician (primary) Taxonomy 2085R0202X · Licence M-17337 (ID)
Neuroradiology Physician Taxonomy 2085N0700X · Licence 30016 (WV)
Neuroradiology Physician Taxonomy 2085N0700X · Licence M-17337 (ID)
Diagnostic Radiology Physician Taxonomy 2085R0202X · Licence 20293 (NV)

Record details

NPI number1891102620
Entity typeIndividual (Type 1)
GenderMale
Credentials MD
Sole proprietorNo
NPI enumeratedJuly 14, 2014
Last updated in NPPESFebruary 11, 2026
Certification dateFebruary 11, 2026

Medicare enrollment

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

Medicare specialtyDIAGNOSTIC RADIOLOGY
Medical schoolOTHER
Graduated 2014 (12 years in practice)
Group practice Kootenai Health Inc — 394 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations6 on file with Medicare

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