Active NPI 1487899365 Individual Practitioner Female Practitioner

Jaclyn Golus Mentzer , PA

Physician Assistant • Boise, ID

✓ Accepts Medicare Assignment

Professional Overview & Biography Verified Profile Summary

Jaclyn Mentzer, PA is a certified Physician Assistant practicing in Boise, ID. With approximately 18 years of clinical experience since completing medical education in 2008, Jaclyn Mentzer delivers high-quality medical care to the local community at 388 E. PARKCENTER BLVD. GEM STATE DERMATOLOGY.

Jaclyn Mentzer is affiliated with Gem State Dermatology Pa and accepts Medicare assignment.

Frequently performed procedures and clinical services include destruction of precancer skin growth, 2-14 growths, established patient outpatient office visit, destruction of skin growth. Full Medicare procedure pricing transparency rates and service volume details are listed on this profile.

Practice Location & Contact Primary Location

Practice Address

388 E. Parkcenter Blvd. Gem State Dermatology

Boise, ID 83706

Telephone 2084249101

Fax 2084245072

Associated Practice Facility / Clinic

🏢 Gem State Dermatology, Pa Facility NPI 1912040270

Medicare Profile & Education

Medical School

Other

Graduation Year

2008

Medicare Assignment

✓ Accepts Assignment

Telehealth Flag

In-Person Only

Specialty Benchmarks & Practice Insights

Comparative analytics for Physician Assistant in Boise, ID

Established Specialist (10-20 Yrs)

Practitioner Clinical Experience

18 Yrs +7.9 yrs vs City Avg

City Avg: 10.1 Yrs

State Avg: 12.4 Yrs

Regional Practice Density

364 Specialists

Practicing in Boise, ID (1261 Statewide)

Telehealth Adoption Rate

12.4% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount

66.0% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Clinical Seniority & Experience Comparison

Dr. Mentzer (18 Years) 18 Yrs

Boise Specialty Average (10.1 Years) 10.1 Yrs

Performed Procedures & Service Volume

Top Medicare Part B procedures performed by this practitioner

CMS Official Data (2024)

Reporting Year:

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
17003 Destruction of precancer skin growth, 2-14 growths	369	83	$15.90	$5.23
99213 Established patient office or other outpatient visit, typically 15 minutes	340	269	$203.48	$72.08
17000 Destruction of skin growth	128	115	$150.14	$46.26
17110 Destruction of up to 14 skin growths	54	45	$252.04	$88.01
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	51	46	$289.43	$100.67
11102 Tangential biopsy of single skin lesion	43	37	$227.65	$71.05
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	24	24	$253.00	$88.05
99212 Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more	23	22	$126.70	$44.65

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
17003 Destruction of precancer skin growth, 2-14 growths	395	80	$14.00	$5.24
99213 Established patient office or other outpatient visit, typically 15 minutes	325	261	$191.00	$71.77
17000 Destruction of skin growth	127	108	$140.00	$44.33
17110 Destruction of up to 14 skin growths	64	54	$235.00	$84.27
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	46	42	$271.00	$100.30
11102 Tangential biopsy of single skin lesion	42	40	$213.00	$71.19
99212 Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more	31	30	$118.00	$44.66
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	31	31	$235.00	$88.51
17261 Destruction of cancer skin growth of trunk, arms, or legs, 0.6-1.0 cm	16	13	$297.10	$109.35

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
17003 Destruction of precancer skin growth, 2-14 growths	434	83	$6.74	$5.25
99213 Established patient office or other outpatient visit, typically 15 minutes	354	266	$91.84	$71.22
17000 Destruction of skin growth	150	121	$66.57	$42.73
17110 Destruction of up to 14 skin growths	64	58	$116.26	$86.77
11102 Tangential biopsy of single skin lesion	60	54	$100.20	$68.75
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	45	45	$114.47	$87.51
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	38	36	$128.01	$101.17
99212 Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more	37	34	$54.02	$44.07
17261 Destruction of cancer skin growth of trunk, arms, or legs, 0.6-1.0 cm	26	20	$162.77	$96.98
17111 Destruction of skin growth, 15 or more growths	14	12	$151.16	$97.81
11103 Biopsy of related skin growth, each additional growth	14	13	$47.11	$39.54
17262 Destruction of cancer skin growth of trunk, arms, or legs, 1.1-2.0 cm	12	11	$165.08	$138.82

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99213 Established patient office or other outpatient visit, typically 15 minutes	355	290	$84.99	$71.88
17003 Destruction of precancer skin growth, 2-14 growths	259	68	$5.99	$5.09
17000 Destruction of skin growth	113	96	$60.87	$45.33
11102 Tangential biopsy of single skin lesion	57	50	$95.47	$76.08
99212 Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more	54	49	$52.10	$44.27
17110 Destruction of up to 14 skin growths	54	50	$105.60	$85.08
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	51	51	$105.77	$88.58
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	44	40	$122.51	$101.12
17261 Destruction of cancer skin growth of trunk, arms, or legs, 0.6-1.0 cm	20	15	$136.19	$101.34
11103 Biopsy of related skin growth, each additional growth	19	11	$48.42	$41.16
11301 Shaving of skin growth of body, arms, or legs, 0.6-1.0 cm	12	11	$129.68	$93.21

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	269	243	$105.62	$86.95
17003 Destruction of precancer skin growth, 2-14 growths	210	47	$5.66	$4.77
99213 Established patient office or other outpatient visit, typically 15 minutes	106	86	$72.39	$59.67
17000 Destruction of skin growth	81	68	$62.09	$44.66
17110 Destruction of up to 14 skin growths	51	50	$111.46	$82.60
11102 Tangential biopsy of single skin lesion	46	42	$95.66	$69.14
99212 Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more	32	29	$43.26	$35.80
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	26	26	$104.04	$85.77
17261 Destruction of cancer skin growth of trunk, arms, or legs, 0.6-1.0 cm	22	20	$135.76	$104.63
99202 New patient office or other outpatient visit, typically 20 minutes	21	21	$76.98	$60.19
17262 Destruction of cancer skin growth of trunk, arms, or legs, 1.1-2.0 cm	12	11	$165.02	$134.36

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	269	248	$104.43	$86.47
17003 Destruction of precancer skin growth, 2-14 growths	223	61	$5.16	$4.34
17000 Destruction of skin growth	98	84	$61.67	$44.18
99213 Established patient office or other outpatient visit, typically 15 minutes	87	80	$70.30	$59.05
17110 Destruction of up to 14 skin growths	59	55	$103.27	$83.31
11102 Tangential biopsy of single skin lesion	52	48	$92.25	$67.60
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	40	40	$104.08	$85.90
99212 Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more	25	24	$42.22	$35.65
99202 New patient office or other outpatient visit, typically 20 minutes	21	21	$71.94	$60.65
17261 Destruction of cancer skin growth of trunk, arms, or legs, 0.6-1.0 cm	19	16	$135.42	$98.61

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
17003 Destruction of precancer skin growth, 2-14 growths	487	99	$4.83	$3.98
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	332	290	$101.33	$83.65
17000 Destruction of skin growth	170	139	$61.85	$42.65
99213 Established patient office or other outpatient visit, typically 15 minutes	161	131	$68.75	$56.45
11100 Biopsy of single growth of skin and/or tissue	81	72	$98.43	$69.17
17110 Destruction of up to 14 skin growths	61	57	$105.08	$79.58
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	43	43	$103.76	$83.35
99212 Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more	35	34	$40.74	$33.71
99202 New patient office or other outpatient visit, typically 20 minutes	34	34	$71.36	$57.19
17261 Destruction of cancer skin growth of trunk, arms, or legs, 0.6-1.0 cm	19	18	$133.55	$98.54
17262 Destruction of cancer skin growth of trunk, arms, or legs, 1.1-2.0 cm	19	15	$169.25	$108.96
17281 Destruction of malignant growth (0.6 to 1.0 centimeters) of face, ears, eyelids, nose, lips, or mouth	18	16	$165.13	$132.57
11101 Biopsy of each additional growth of skin and/or tissue	15	13	$30.24	$25.04

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
17003 Destruction of precancer skin growth, 2-14 growths	531	115	$5.24	$4.22
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	324	279	$102.63	$83.81
17000 Destruction of skin growth	193	155	$62.50	$42.37
99213 Established patient office or other outpatient visit, typically 15 minutes	179	146	$70.04	$56.25
11100 Biopsy of single growth of skin and/or tissue	98	86	$98.83	$69.24
J3301 Injection, triamcinolone acetonide, not otherwise specified, 10 mg	89	11	$1.77	$1.74
17110 Destruction of up to 14 skin growths	68	67	$102.47	$81.26
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	51	51	$102.88	$82.62
99212 Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more	46	44	$40.71	$33.68
99202 New patient office or other outpatient visit, typically 20 minutes	36	36	$70.28	$57.81
11101 Biopsy of each additional growth of skin and/or tissue	21	15	$31.81	$24.44
17262 Destruction of cancer skin growth of trunk, arms, or legs, 1.1-2.0 cm	17	13	$162.46	$113.90
17261 Destruction of cancer skin growth of trunk, arms, or legs, 0.6-1.0 cm	15	14	$132.96	$94.59
12032 Intermediate repair of wound of scalp, underarms, trunk, arms, or legs, 2.6-7.5 cm	11	11	$281.08	$231.28

Medical Specialties & State Licenses

CMS Verified: 2020-01-27

Physician Assistant Primary Specialty

NUCC Taxonomy Code: 363A00000X

State License ID PA-773

A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician.

Dermatology

NUCC Taxonomy Code: 207N00000X

State License ID M7247

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.

Physician Assistant

NUCC Taxonomy Code: 363A00000X

State License ID PA773

Additional State Medicaid & Healthcare Payer Identifiers

Medicaid State Provider ID

808380800 (ID)

Hospital & Practice Group Affiliations

Gem State Dermatology Pa

388 E Parkcenter Blvd, Boise, ID 837063942

Phone: 2084249101

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

3 Associated Practitioners

Katherine Ledford , PA

Physician Assistant

NPI 1386233997

Physician Assistant

Dr. Steven Mings , MD

Dermatology

NPI 1548214265

Doctor of Medicine (M.D.)

Michael Lane , PA-C

Physician Assistant

NPI 1669415188

Physician Assistant (Certified)

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

9 Historical Events

📍

Updated Practice Location January 27, 2020

Registered at 388 E. PARKCENTER BLVD. GEM STATE DERMATOLOGY, BOISE, ID 83706 (Tel: 2084249101)

📍

Updated Business Mailing Address January 27, 2020

Registered at 388 E. PARKCENTER BLVD. GEM STATE DERMATOLOGY, BOISE, ID 83706 (Tel: 2084249101)

👤

Provider Name / Credentials Updated January 27, 2020

Recorded as JACLYN MENTZER, P.A.

✅

NPI Profile Active December 02, 2014

NPI status registered as active in NPPES database

📍

Updated Practice Location December 02, 2014

Registered at 388 E. PARKCENTER BLVD., BOISE, ID 83706 (Tel: 2084249101)

📍

Updated Business Mailing Address December 02, 2014

Registered at PO BOX 1603, BOISE, ID 837021603 (Tel: 2084249101)

👤

Provider Name / Credentials Updated December 02, 2014

Recorded as JACLYN GOLUS, PA-C

🎓

Medical Taxonomy / Specialty Registered (Primary Specialty) December 02, 2014

Dermatology (License #M7247 in ID)

🟢

Initial NPI Registration & Enumeration December 08, 2008

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1487899365

Entity Type:

Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)

Enumeration Date: December 08, 2008

Last Update: January 27, 2020

Sole Proprietor: No

Update or Correct Profile

Mailing Address

388 E. Parkcenter Blvd. Gem State Dermatology

Boise, ID 83706

Phone: 2084249101

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).

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