NPI age
14 years
Enumerated 2011-06-16
● Active
Type 1 · Individual
DR. Jacob Adam Mong, D.O.
Mong is 1 of 36 ophthalmology providers in Boise and 1 of 122 in Idaho.
Primary specialty
Ophthalmology
Plus 1 subspecialty
Licensed in
ID, MI
2 states
Status
Active
No deactivations on record
Last NPPES update
2023-05-08
Source: monthly bulk 2026-05
Sole proprietor
No
May be part of a larger org
How this provider compares
Across 122 active ophthalmology providers in Idaho.
NPI age
14 years
↓ 5 yr below median (19 yr)
State licenses
2 states
Top 87% — 12% of peers are multi-state
Subspecialties
0
27% of peers hold subspecialties
NPI lifetime · 2011 → 2026
2011-06Enumerated in NPPES
2011
2026
Where they practice
Practice location
5680 W Gage St
Boise, ID 837061326
Mailing address
5680 W Gage St
Boise, ID 837061326
Additional practice locations
2 secondary locations on file with NPPES.
Location 2
350 East Ln S
Ontario, OR 979143058
Location 3
3025 W Cherry Ln Ste 207
Meridian, ID 836428530
Specialties
-
Ophthalmology PrimaryAn ophthalmologist has the knowledge and professional skills needed to provide comprehensive eye and vision care. Ophthalmologists are medically trained to diagnose, monitor and medically or surgically treat all ocular and visual...
Identifiers
| Type | Value | Notes |
|---|---|---|
| 05 (ID) | 1346535481 | |
| 01 (ID) | 20006959 | MEDICARE PTAN |
Multi-state credentialing: Licensed in 2 states. Useful context for credentialers building cross-state provider networks.
Practice context
Part of a multi-provider practice. 10 other active providers share this practice address in NPPES.
Provyx · Custom healthcare lists
Need all 122 Ophthalmology providers in Idaho?
Get the full list as a CSV with verified work emails, direct phones, and LinkedIn URLs.
Request a quote →How to verify this provider
- Confirm the NPI on NPPES.The CMS registry is the system of record. Open NPPES →
- Check the state license is currently active.State licensing boards publish current status; NPPES does not.
- Confirm payer enrollment if billing.NPI presence does not guarantee active enrollment with Medicare, Medicaid, or commercial payers.