DEBLIECK DERMATOLOGY
NPI 1497960983
Dermatology in Boise, ID

NPI Status: Active since May 10, 2007

Contact Information

13176 W PERSIMMON LN
BOISE, ID
ZIP 83713
Phone: (208) 939-5030
Fax: (208) 939-1892

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  • Organization
  • Dermatology
  • Accepts Insurance
  • CLIA Number: 13D1044436
  • CLIA Cert. Type: Physician Office
  • CLIA Exp. Date: 01-23-2026

About DEBLIECK DERMATOLOGY

This page provides the complete NPI Profile along with additional information for Deblieck Dermatology, a provider established in Boise, Idaho operating as a Dermatology. The healthcare provider is registered in the NPI registry with number 1497960983 assigned on May 2007. The practitioner's primary taxonomy code is 207N00000X with license number M7045 (ID). The provider is registered as an organization and their NPI record was last updated 18 years ago. The organization operates as a single speciality business group with one or more individual providers who practice the same area of specialization. The provider's is doing business as Deblieck Dermatology. The authorized official of this NPI record is Dr. Jennifer Deblieck M.d. (Physician-owner)

NPI
1497960983
Provider Legal Name
JAN DEBLIECK MD PA
Other Organization Name
DEBLIECK DERMATOLOGY
Other Name Type
Doing Business As (3)
Entity Type
Organization
Location Address
13176 W PERSIMMON LN BOISE, ID 83713
Location Phone
(208) 939-5030
Location Fax
(208) 939-1892
Mailing Address
13176 W PERSIMMON LN BOISE, ID 83713
Mailing Phone
(208) 939-5030
Mailing Fax
(208) 939-1892
Is Sole Proprietor?
No
Is Organization Subpart?
No
Enumeration Date
05-10-2007
Last Update Date
07-17-2007
Code Navigator

A dermatologist like Deblieck Dermatology is a medical specialty involving the management of skin conditions and diseases. Dermatologists diagnose some sexually transmitted diseases, warts, cancer, acne, dermatitis and may offer cosmetic treatments, and therapies that reduce age spots and wrinkles.

Location Map

Specialty - Primary Taxonomy

The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Classification

Dermatology

Taxonomy Code
207N00000X
Type
Allopathic & Osteopathic Physicians
License No.
M7045
License State
ID
Taxonomy Description
A dermatologist is trained to diagnose and treat pediatric and adult patients with benign and malignant disorders of the skin, mouth, external genitalia, hair and nails, as well as a number of sexually transmitted diseases. The dermatologist has had additional training and experience in the diagnosis and treatment of skin cancers, melanomas, moles and other tumors of the skin, the management of contact dermatitis and other allergic and nonallergic skin disorders, and in the recognition of the skin manifestations of systemic (including internal malignancy) and infectious diseases. Dermatologists have special training in dermatopathology and in the surgical techniques used in dermatology. They also have expertise in the management of cosmetic disorders of the skin such as hair loss and scars and the skin changes associated with aging.

Group Taxonomy 193400000X SINGLE SPECIALTY GROUP

This provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.

Insurance Plans Accepted

According to publicly available information the provider might be accepting the following health plans from these health insurance companies:

  • Connect Bronze Expanded Standard - PPO
  • Connect Bronze HDHP - PPO
  • Connect Catastrophic - PPO
  • Connect Gold - PPO
  • Connect Gold Standard - PPO
  • Connect Silver - PPO
  • Connect Silver Standard - PPO
  • High Plains Bronze HDHP - PPO
  • High Plains Bronze Standard Expanded - PPO
  • High Plains Gold - PPO
  • High Plains Gold HDHP - PPO
  • High Plains Gold Standard - PPO
  • High Plains Silver - PPO
  • High Plains Silver Standard - PPO
  • Plus Bronze Expanded - PPO
  • Plus Bronze Standard Expanded - PPO
  • Plus Gold - PPO
  • Plus Gold Standard - PPO
  • Plus Silver Standard - PPO
  • ACCESS BRONZE - PPO

Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.

Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.

*Please verify directly with this provider to make sure your insurance plan is currently accepted.

Authorized Official

The authorized official is the designated individual with the legal authority to make changes to the provider’s official NPI record. For organizations, the authorized official must be a general partner, chairman of the board, CEO, CFO or a direct owner holding at least a 5 percent stake in the medical organization.

Authorized Official Name

DR. JENNIFER DEBLIECK M.D.

Authorized Official Title
PHYSICIAN-OWNER
Authorized Official Phone
(208) 939-5030

Additional Identifiers

The NPI Enumerator encourages providers to submit additional identifiers with their NPI application although the submission of this information is optional. The additional identifier(s) section includes other numbers or codes currently or formerly used as an identifier for the provider by other public healthcare entities. The identifiers may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.

Identifier Type / Code Identifier State Identifier Issuer
G37337MEDICARE UPIN (02)ID 
1368446MEDICARE OSCAR/CERTIFICATION (06)ID 

CLIA Information

The Clinical Laboratory Improvement Amendments (CLIA) of 1988 applies to facilities or sites that test human specimens for health assessment or to diagnose, prevent, or treat disease. The CLIA Program sets standards for clinical laboratory testing and issues certificates. The NPI / CLIA crosswalk information for this NPI number is:

CLIA Number
13D1044436
Facility Type
Physician Office
Certificate Effective Date
January 24, 2024
Certificate Expiration Date
January 23, 2026
Laboratory Director
JENNIFER A. DEBLIECK
Certificate Type
Certificate for Provider-Performed Microscopy Procedures (PPMP)
Certificate Type Description
This CLIA certificate is issued to Deblieck Dermatology in which a physician, midlevel practitioner or dentist that performs specific microscopy procedures during the course of a patient's visit. A limited list of provider-performed microscopy procedures is included under this certificate type, which are categorized as moderate complexity testing.

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NPI Validation Check Digit Calculation


The following table explains the step by step NPI number validation process using the ISO standard Luhn algorithm.

Start with the original NPI number, the last digit is the check digit and is not used in the calculation.
1497960983
Step 1: Double the value of the alternate digits, beginning with the rightmost digit.
241871860916
Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24.
2 + 4 + 1 + 8 + 7 + 1 + 8 + 6 + 0 + 9 + 1 + 6 + 24 = 77
Step 3: Subtract the total obtained in step 2 from the next higher number ending in zero, the result is the check digit.
80 - 77 = 33

The NPI number 1497960983 is valid because the calculated check digit 3 using the Luhn validation algorithm matches the last digit of the original NPI number.

Other Providers at the Same Location


The following 6 providers are registered at the same or nearby location.

NPI Name / Type Taxonomy Address
1609822402 BREK DAVID STOKER AUD, CCC-A
Individual
Specialist13176 W PERSIMMON LN #120
BOISE, ID 83713
(208) 376-3591
1861421240DR. JENNIFER ANN DEBLIECK MD
Individual
Dermatology13176 W PERSIMMON LN
BOISE, ID 83713
(208) 939-5030
1679796585MRS. ALESIA J. HITCHCOCK M.S.
Individual
Speech-Language Pathologist13176 W PERSIMMON LN SUITE 120
BOISE, ID 83713
(208) 376-3591
1750504163DR. VICTOR HERBERT HORCH D.C.
Individual
Chiropractor13176 W PERSIMMON LN SUITE 110
BOISE, ID 83713
(208) 321-0044
1104099589BOISE SPEECH AND HEARING CLINIC
Organization
Speech-Language Pathologist13176 W PERSIMMON LN SUITE 120
BOISE, ID 83713
(208) 376-3591
1972988210 JESS SEYMOUR BOEDER MS., CCC, SLP
Individual
Speech-Language Pathologist13176 W PERSIMMON LN STE. 120
BOISE, ID 83713
(208) 376-3591

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1497960983, enumerated in the NPI registry as an "organization" on May 10, 2007

The provider is located at 13176 W Persimmon Ln Boise, Id 83713 and the phone number is (208) 939-5030

This medical organization specializes in Dermatology with taxonomy code 207N00000X

The provider might be accepting Accepts: Mountain Health CO-OP, Medicare and Medicaid. Please consult your insurance carrier or call the provider to make sure your health plan is currently accepted.

The provider's CLIA number is 13D1044436 for a "physician office" facility with a CLIA Certificate for Provider-Performed Microscopy Procedures (PPMP). This CLIA certificate is issued in which a physician, midlevel practitioner or dentist that performs specific microscopy procedures during the course of a patient's visit. A limited list of provider-performed microscopy procedures is included under this certificate type, which are categorized as moderate complexity testing..

This NPI record was last updated on May 10, 2007. To officially update your NPI information contact the National Plan and Provider Enumeration System (NPPES) at 1-800-465-3203 (NPI Toll-Free) or by email at [email protected].
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