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

Mrs. Jaclyn Golus Mentzer, PA

Individual provider Dermatology Physician · NPI 1487899365

Mrs. Jaclyn Golus Mentzer, PA is a Physician Assistant in Boise, Idaho. Qualified in 2008, 18 years ago. Practices with Gem State Dermatology PA, a 6-clinician group and accepts Medicare assignment. Licensed in Idaho.

Years since qualifying
18
Licensed in
ID
In the registry since
2008
Specialties on file
3
What do these letters mean?
PA — Physician Assistant
A licensed clinician who examines, diagnoses and treats under a physician's supervision.

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Practice location Address checks out

388 E Parkcenter Blvd Gem State Dermatology
Boise, ID 83706
Phone: (208) 424-9101
Fax: (208) 424-5072
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence PA-773 (ID)
Dermatology Physician Taxonomy 207N00000X · Licence M7247 (ID)
Physician Assistant Taxonomy 363A00000X · Licence PA773 (ID)

Record details

NPI number1487899365
Entity typeIndividual (Type 1)
GenderFemale
Credentials PA
Sole proprietorNo
NPI enumeratedDecember 8, 2008
Last updated in NPPESJanuary 27, 2020
Certification dateJanuary 27, 2020

Medicare enrollment

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

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2008 (18 years in practice)
Group practice Gem State Dermatology Pa — 6 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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