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

Jacob Shane Tebbs, PA-C

Individual provider Medical Physician Assistant · NPI 1154870251

Jacob Shane Tebbs, PA-C is a Physician Assistant in Boise, Idaho. Qualified in 2016, 10 years ago. Practices with High Valley Dermatology and Dermatologic Surgery PLLC, a 9-clinician group, works from 2 locations and accepts Medicare assignment. Licensed in Utah.

Years since qualifying
10
Licensed in
UT
In the registry since
2016
What do these letters mean?
PA-C — Physician Assistant, Certified
A physician assistant who holds current national certification.

See every abbreviation used in this directory →

Claim this listing Report a problem Suggest an edit

Practice location Address checks out

6051 N Eagle Rd
Boise, ID 83713-0997
Phone: (208) 519-4333
Fax: (208) 205-9134
Show map & directions

Directions in Google Maps · Apple Maps · OpenStreetMap

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

Additional practice locations (1)

  • 999 N Curtis Rd Ste 307, Boise, ID 83706-1333 — (208) 519-4333

Specialties & licences

Medical Physician Assistant (primary) Taxonomy 363AM0700X · Licence 10103875-1206 (UT)

Record details

NPI number1154870251
Entity typeIndividual (Type 1)
GenderMale
Credentials PA-C
Sole proprietorNo
NPI enumeratedSeptember 29, 2016
Last updated in NPPESAugust 7, 2020
Certification dateAugust 7, 2020

Medicare enrollment

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

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2016 (10 years in practice)
Group practice High Valley Dermatology And Dermatologic Surgery Pllc — 9 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations3 on file with Medicare

Other providers in Boise