JACK C JR. CHAFFIN (MD) – Anatomic Pathology & Clinical Pathology Physician, NPI 1104867662
Anatomic Pathology & Clinical Pathology Physician
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Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
33 PATHOLOGY in ID
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Provider Addresses for JACK C JR. CHAFFIN (MD)
Saint Alphonsus Regional Medical Center, 1055, North Curtis Road, Boise Junction, Boise, Ada County, Idaho, 83706, United States
BOISE, ID 837061309
Phone: (208) 367-2152
Type: Location
PO BOX 9589
BOISE, ID 837074589
Phone: (208) 472-8109
Fax: (208) 472-8172
Type: Mailing
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
No Open Payments data available for this provider.
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Medicare Enrollment & Revalidation
Source: CMS public data · Not endorsed by CMS ·
Educational use only—not medical, billing, or legal advice.
PECOS enrollment status
Participating (accepts Medicare assignment)
Enrollment effective: 2004-02-10
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.
Enrollment records
1
Earliest due date
Not assigned (TBD)
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20040210000424 | I | Pathology | ID | TBD |
What to do next
- No action required while the due date shows TBD.
- Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
- Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.
Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS
Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
Educational use only—not medical, billing, or legal advice.
Top Medicare procedures (2023) · refreshed 2026-05-27
| HCPCS | Description | Services | Beneficiaries | Medicare allowed |
|---|---|---|---|---|
| 88305 | Pathology examination of tissue using a microscope, intermediate complexity | 544 | 336 | $0 |
| 88307 | Pathology examination of tissue using a microscope, moderately high complexity | 231 | 128 | $0 |
| 84165 | Protein measurement, serum | 228 | 173 | $0 |
| 88341 | Special stained specimen slides to examine tissue, each additional procedure | 186 | 59 | $0 |
| 88342 | Special stained specimen slides to examine tissue, initial procedure | 132 | 101 | $0 |
Insurance plans in this area (ZIP 83706)
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Provider's Procedures
| Specialty | Practice State | HCPCS Code | Description | Service Count | Beneficiary Count |
|---|---|---|---|---|---|
| PATHOLOGY | ID | 88304 | Pathology examination of tissue using a microscope, moderately low complexity | 96 | 83 |
| PATHOLOGY | ID | 88307 | Pathology examination of tissue using a microscope, moderately high complexity | 132 | 77 |
| PATHOLOGY | ID | 88342 | Tissue or cell analysis by immunologic technique | 78 | 64 |
Group practice members
| Name | Specialty | State |
|---|---|---|
| Qualified Audiologist | ID | |
| Orthopedic Surgery | ID | |
| - | ID | |
| - | UT | |
| Family Practice | ID | |
| Physician Assistant | ID | |
| - | ID | |
| Internal Medicine | ID | |
| Family Practice | ID | |
| - | ID |
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