Samuel S Jorgenson (NPI# 1962447169, PAC ID# 0244142693) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is ORTHOPEDIC SURGERY.
| Nation Provider ID (NPI) | 1962447169 |
| PAC ID by PECOS | 0244142693 |
| Professional Enrollment ID | I20050128000392 |
| Full Name | Samuel S Jorgenson |
| Organization Legal Name | SPINE INSTITUTE OF IDAHO PA |
| Address |
360 E Montvue Dr Suite 100 Meridian ID 83642-6318 |
| Phone Number | 2088552900 |
| Gender | M |
| Credential | MD |
| Medical School | HAHNEMAN MEDICAL COLLEGE OF THE PACIFIC |
| Graduation Year | 1986 |
| Primary Specialty | ORTHOPEDIC SURGERY |
| Group Practice PAC ID | 6608837265 |
| Number of Group Practice Members | 10 |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 130006 | ST LUKE'S REGIONAL MEDICAL CENTER |
| 130014 | WEST VALLEY MEDICAL CENTER |
| 130071 | ST LUKE'S NAMPA MEDICAL CENTER |
| Address | Phone | Organization |
|---|---|---|
| 360 E Montvue Dr, Suite 100, Meridian, ID 83642-6318 | 2088552900 | SPINE INSTITUTE OF IDAHO PA |
| Organization Legal Name | SPINE INSTITUTE OF IDAHO PA |
| Physicians | 13 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Michael R Glover | Orthopedic Surgery | Spine Institute of Idaho Pa | 360 E Montvue Dr, Suite 100, Meridian, ID 83642-6318 |
| Sari B Lavarias | Physician Assistant | Spine Institute of Idaho Pa | 360 E Montvue Dr, Suite 100, Meridian, ID 83642-6318 |
| Donald J Blaskiewicz | Neurosurgery | Spine Institute of Idaho Pa | 360 E Montvue Dr, Suite 100, Meridian, ID 83642-6318 |
| Lucas D Robinson | Physician Assistant | Spine Institute of Idaho Pa | 1906 Fairview Ave, Suite 420, Caldwell, ID 83605-5425 |
| Michael B Spackman | Physical Medicine and Rehabilitation | Spine Institute of Idaho Pa | 1906 Fairview Ave, Suite 420, Caldwell, ID 83605-5425 |
| Beth S Rogers | Physical Medicine and Rehabilitation | Spine Institute of Idaho Pa | 360 E Montvue Dr, Suite 100, Meridian, ID 83642-6318 |
| Eric Scott Varley | Orthopedic Surgery | Spine Institute of Idaho Pa | 360 E Montvue Dr, Suite 100, Meridian, ID 83642-6318 |
| Alicia J Henrich | Physician Assistant | Spine Institute of Idaho Pa | 1906 Fairview Ave, Suite 420, Caldwell, ID 83605-5425 |
| Gunjan D Patel | Physical Therapy | Spine Institute of Idaho Pa | 360 E Montvue Dr, Suite 100, Meridian, ID 83642-6318 |
| Stephanie C Mooney | Nurse Practitioner | Spine Institute of Idaho Pa | 360 E Montvue Dr, Suite 100, Meridian, ID 83642-6318 |
| Street Address |
360 E MONTVUE DR SUITE 100 |
| City | MERIDIAN |
| State | ID |
| Zip | 83642-6318 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Michael R Glover | Orthopedic Surgery | Spine Institute of Idaho Pa | 360 E Montvue Dr, Suite 100, Meridian, ID 83642-6318 |
| Sari B Lavarias | Physician Assistant | Spine Institute of Idaho Pa | 360 E Montvue Dr, Suite 100, Meridian, ID 83642-6318 |
| Donald J Blaskiewicz | Neurosurgery | Spine Institute of Idaho Pa | 360 E Montvue Dr, Suite 100, Meridian, ID 83642-6318 |
| Beth S Rogers | Physical Medicine and Rehabilitation | Spine Institute of Idaho Pa | 360 E Montvue Dr, Suite 100, Meridian, ID 83642-6318 |
| Eric Scott Varley | Orthopedic Surgery | Spine Institute of Idaho Pa | 360 E Montvue Dr, Suite 100, Meridian, ID 83642-6318 |
| Gunjan D Patel | Physical Therapy | Spine Institute of Idaho Pa | 360 E Montvue Dr, Suite 100, Meridian, ID 83642-6318 |
| Stephanie C Mooney | Nurse Practitioner | Spine Institute of Idaho Pa | 360 E Montvue Dr, Suite 100, Meridian, ID 83642-6318 |
| Molly M Hodge | Physical Therapy | Spine Institute of Idaho Pa | 360 E Montvue Dr, Suite 100, Meridian, ID 83642-6318 |
| Robert C Mcdonald | Physician Assistant | Spine Institute of Idaho Pa | 360 E Montvue Dr, Suite 100, Meridian, ID 83642-6318 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Kurt Slonaker | Chiropractic | 3329 W Cherry Ln, Meridian, ID 83642-1119 | |
| Katy F Connley | Nurse Practitioner | Saint Alphonsus Regional Medical Center Inc | 3250 W Cherry Ln, Meridian, ID 83642-1120 |
| Diana Menchaca | Psychologist, Clinical | 1711 S Millenium Way, Suite 110, Meridian, ID 83642-1504 | |
| Virginia P Haviland | Psychologist, Clinical | 1711 S Millennium Way, Suite 110, Meridian, ID 83642-1504 | |
| Cheri Thomas | Nurse Practitioner | Alliance Medical Group LLC | 3115 E Florence, Meridian, ID 83642-1586 |
| Angela L Hansen | Clinical Social Worker | 403 W Cherry Ln, Finding The Silver Lining, Meridian, ID 83642-1610 | |
| Matthew L Jordan | Nurse Practitioner | Vibra Physicians LLC | 2131 S Bonito Way, Meridian, ID 83642-1659 |
| Dan J Hendrickson | Pulmonary Disease | Vibra Physicians LLC | 2131 S Bonito Way, Meridian, ID 83642-1659 |
| Huiling Qi | Internal Medicine | Vibra Physicians LLC | 2131 S Bonito Way, Meridian, ID 83642-1659 |
| Robert E Shumaker | Physician Assistant | Vibra Physicians LLC | 2131 S Bonito Way, Meridian, ID 83642-1659 |
| Find all physicians in zip 83642 | |||
| City | MERIDIAN |
| Zip Code | 83642 |
| Specialty | ORTHOPEDIC SURGERY |
| City + Specialty | MERIDIAN + ORTHOPEDIC SURGERY |
Please comment or provide details below to improve the information on Samuel S Jorgenson.
| Data Provider | Centers for Medicare & Medicaid Services (CMS) |
| Jurisdiction | Medicare |
This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.