OrganizationActive
Gem State Dermatology, PA
NPI 1912040270 · Dermatology Physician · Boise, ID
Provider details
- NPI number
- 1912040270
- Entity type
- Organization
- Primary specialty
- Dermatology PhysicianAllopathic & Osteopathic Physicians
- Organization subpart
- No
- Authorized official
- Michelle Morgan, Practice Manager(208) 424-9101
- License
- M7247 (ID)
Specialties & taxonomies
Allopathic & Osteopathic Physicians
Ambulatory Health Care Facilities
Physician Assistants & Advanced Practice Nursing Providers
Profile Score
Detailed profile(89/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
19 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
388 E. Parkcenter Blvd.
Boise, ID 83706
Phone: (208) 424-9101
Fax: (208) 424-5072
Street-level locationGet directions
Mailing address
Po Box 1603
Boise, ID 83702-1603
Registry dates
- Enumerated
- 2007-02-15
- Last updated
- 2014-12-02
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.