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

Tyshae Jaggi, DO

Individual provider Family Medicine Physician · NPI 1972127942

Tyshae Jaggi, DO is a Family Practice in Pocatello, Idaho. Qualified in 2020, 6 years ago. Practices with Madison Memorial Hospital, a 20-clinician group and accepts Medicare assignment. Licensed in Idaho.

Years since qualifying
6
Licensed in
ID
In the registry since
2020
What do these letters mean?
DO — Doctor of Osteopathic Medicine
A fully licensed physician, trained like an MD with additional musculoskeletal training. Equivalent practice rights in all 50 states.

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Practice location Address checks out

465 Memorial Dr
Pocatello, ID 83201-4008
Phone: (208) 232-7862
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Family Medicine Physician (primary) Taxonomy 207Q00000X · Licence O-1597 (ID)

Record details

NPI number1972127942
Entity typeIndividual (Type 1)
GenderFemale
Credentials DO
Sole proprietorYes
NPI enumeratedJune 4, 2020
Last updated in NPPESJuly 28, 2023
Certification dateJuly 7, 2023
Mailing address500 S 11th Ave Ste 400, Pocatello, ID 83201-4880

Medicare enrollment

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

Medicare specialtyFAMILY PRACTICE
Medical schoolOTHER
Graduated 2020 (6 years in practice)
Group practice Madison Memorial Hospital — 20 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations2 on file with Medicare

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