Gem State Dermatology, PA
NPI 1912040270 · Dermatology Physician · Boise, ID
Enrolled with Medicare as Part B Supplier - Clinic/Group Practice · source: CMS PECOS Public Provider Enrollment (2026.04.01)
Gem State Dermatology, PA is a Dermatology Physician organization in Boise, ID (NPI 1912040270).
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
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
Mailing address
Registry dates
- Enumerated
- 2007-02-15
- Last updated
- 2014-12-02
Frequently asked questions
- What is Gem State Dermatology, PA's NPI number?
- Gem State Dermatology, PA's National Provider Identifier (NPI) is 1912040270, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What type of organization is Gem State Dermatology, PA?
- Gem State Dermatology, PA is classified in the NPPES registry as Dermatology Physician (Allopathic & Osteopathic Physicians).
- Where is Gem State Dermatology, PA located?
- Gem State Dermatology, PA's practice location on file with NPPES is 388 E. Parkcenter Blvd., Boise, ID 83706.
- What is Gem State Dermatology, PA's phone number?
- The practice phone number listed in the NPPES registry for Gem State Dermatology, PA is (208) 424-9101.
- Does Gem State Dermatology, PA accept Medicare?
- Gem State Dermatology, PA is approved to bill Medicare according to CMS PECOS enrollment data (2026.04.01). Confirm current participation with the provider before scheduling.
- Who is the authorized official for Gem State Dermatology, PA?
- The authorized official listed on Gem State Dermatology, PA's NPPES record is Michelle Morgan, Practice Manager. The authorized official registers and maintains the organization's NPI and is not necessarily its owner.
- Is Gem State Dermatology, PA's NPI active?
- Yes — Gem State Dermatology, PA's NPI (1912040270) is active in the NPPES registry as of the last update on 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.