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

Jason M Ellison, MD

Individual provider Pediatrics Physician · NPI 1740231455

Jason M Ellison, MD is a Pediatric Medicine in Boise, Idaho. Graduated from University of Iowa, Rj & L Carver College of Medicine in 2002, 24 years ago. Practices with Saint Alphonsus Regional Medical Center Inc, a 673-clinician group and accepts Medicare assignment. Licensed in Idaho.

Years since qualifying
24
Trained at
University of Iowa, Rj & L Carver College of Medicine
Licensed in
ID
In the registry since
2006
Specialties on file
2
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

1072 N Liberty St Ste 200
Boise, ID 83704
Phone: (208) 302-4600
Fax: (208) 302-4655
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Pediatric Gastroenterology Physician (primary) Taxonomy 2080P0206X · Licence M-10380 (ID)
Pediatrics Physician Taxonomy 208000000X · Licence M10380 (ID)

Record details

NPI number1740231455
Entity typeIndividual (Type 1)
GenderMale
Credentials MD
Sole proprietorNo
NPI enumeratedMay 15, 2006
Last updated in NPPESApril 25, 2018
Mailing address3340 E Goldstone Way, Meridian, ID 83642

Medicare enrollment

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

Medicare specialtyPEDIATRIC MEDICINE
Medical schoolUNIVERSITY OF IOWA, RJ & L CARVER COLLEGE OF MEDICINE
Graduated 2002 (24 years in practice)
Group practice Saint Alphonsus Regional Medical Center Inc — 673 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations2 on file with Medicare

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