Mrs Jaclyn Golus Mentzer, PA is a medicare enrolled "Physician Assistant" physician in Boise, Idaho. She graduated from medical school in 2008 and has 17 years of diverse experience with area of expertise as Physician Assistant. She is a member of the group practice Gem State Dermatology Pa and her current practice location is
388 E. Parkcenter Blvd. Gem State Dermatology, Boise, Idaho. You can reach out to her office (for appointments etc.) via phone at
(208) 424-9101.
Mrs Jaclyn Golus Mentzer is licensed to practice in Idaho (license number PA-773) and she also participates in the medicare program. She
accepts medicare assignments (which means she accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance) and her NPI Number is 1487899365.
Physician's Profile
Full Name | Mrs Jaclyn Golus Mentzer |
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Gender | Female |
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Speciality | Physician Assistant |
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Experience | 17 Years |
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Location | 388 E. Parkcenter Blvd. Gem State Dermatology, Boise, Idaho |
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Accepts Medicare Assignments | Yes. She accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
Medical Education and Training:
- Mrs Jaclyn Golus Mentzer graduated from medical school in 2008
NPI Data:
- NPI Number: 1487899365
- Provider Enumeration Date: 12/08/2008
- Last Update Date: 01/27/2020
Medicare PECOS Information:
- PECOS PAC ID: 2567514847
- Enrollment ID: I20090716000779
Medical Identifiers
Medical identifiers for Mrs Jaclyn Golus Mentzer such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier | Type | State | Issuer |
1487899365 | NPI | - | NPPES |
808380800 | Medicaid | ID | |
Medical Taxonomies and Licenses
Taxonomy | Type | License (State) | Status |
207N00000X | Dermatology | M7247 (Idaho) | Secondary |
363A00000X | Physician Assistant | PA773 (Idaho) | Secondary |
363A00000X | Physician Assistant | PA-773 (Idaho) | Primary |
Group Practice Association
Group Practice Name | Group PECOS PAC ID | No. of Members |
Gem State Dermatology Pa | 6901700269 | 5 |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Mrs Jaclyn Golus Mentzer is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
Mailing Address | Practice Location Address |
Mrs Jaclyn Golus Mentzer, PA 388 E. Parkcenter Blvd. Gem State Dermatology, Boise, ID 83706 Ph: (208) 424-9101 | Mrs Jaclyn Golus Mentzer, PA 388 E. Parkcenter Blvd. Gem State Dermatology, Boise, ID 83706 Ph: (208) 424-9101 |
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