PEND OREILLE SURGERY CENTER LLC NPI 1821276353

NPI Information

  • NPI: 1821276353
  • Provider Name: PEND OREILLE SURGERY CENTER LLC
  • Classification: Clinic/Center - 261QA1903X
  • Specialization: Ambulatory Surgical
  • Entity Type: Organization
  • CLIA Number: 13D1086286
  • Address: 30544 HIGHWAY 200
    SUITE 201
    PONDERAY, ID
    ZIP 83852
  • Phone: (208) 265-8194

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NPI Details

PEND OREILLE SURGERY CENTER LLC is an ambulatory surgical clinic center in Ponderay, ID. PEND OREILLE SURGERY CENTER LLC NPI is 1821276353. The provider is registered as an organization entity type.

The provider's business location address is:

30544 HIGHWAY 200
SUITE 201
PONDERAY, ID
ZIP 83852-005
Phone: (208) 265-8194
Fax: (208) 265-4870

The provider's authorized official is Kristi Sabo .
The authorized official title is Executive Director and has the following contact phone number (208) 265-8194.

The CLIA number assigned to this NPI record is 13D1086286 - ambulatory surgery center with a certificate type of Certificate of Waiver.

The following top HCPCS codes were publicly reported for this provider under the Medicare program for the year 2016. The reported codes are based on the top codes for each available Medicare specialty, excluding evaluation and management codes.

  • Biopsy of large bowel using a flexible endoscope (HCPCS:45380)
  • Biopsy of esophagus, stomach, and/or upper small bowel using a flexible endoscope (HCPCS:43239)
  • Colorectal cancer screening; colonoscopy on individual at high risk (HCPCS:G0105)
  • Colorectal cancer screening; colonoscopy on individual not meeting criteria for high risk (HCPCS:G0121)
  • Removal of polyps or growths of large bowel using an endoscope with mechanical snare (HCPCS:45385)
  • Diagnostic exam of large bowel using a flexible endoscope (HCPCS:45378)
  • Removal of external hemorrhoids by rubber banding (HCPCS:46221)
  • Insertion of guide wire with dilation of esophagus using a flexible endoscope (HCPCS:43248)
  • Replacement of knee joint, both sides of knee (HCPCS:27447)

The enumeration date for this NPI number is 2/6/2008 and was last updated on 4/27/2012.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1261QA1903XClinic/CenterAmbulatory SurgicalYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1808553900MEDICAIDIDAHO
21870013MEDICARE PIN

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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