IDAHO SURGICENTER INC NPI 1992759930

NPI Information

  • NPI: 1992759930
  • Provider Name: IDAHO SURGICENTER INC
  • Classification: Clinic/Center - 261QA1903X
  • Specialization: Ambulatory Surgical
  • Entity Type: Organization
  • Doing Business As: IDAHO SURGICENTER SOUTH
  • CLIA Number: 13D0970668
  • Address: 1157 CALL PLACE
    POCATELLO, ID
    ZIP 83201
  • Phone: (208) 238-6337

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NPI Details

IDAHO SURGICENTER INC is an ambulatory surgical clinic center in Pocatello, ID. IDAHO SURGICENTER INC NPI is 1992759930. The provider is registered as an organization entity type and is a multi-specialty group.
The provider Is Doing Business As Idaho Surgicenter South.

The provider's business location address is:

1157 CALL PLACE
POCATELLO, ID
ZIP 83201
Phone: (208) 238-6337
Fax: (208) 776-5510

The provider's authorized official is Sean Barnard .
The authorized official title is Administrator and has the following contact phone number (208) 852-6242.

The CLIA number assigned to this NPI record is 13D0970668 - 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.

  • Correction of toe joint deformity (HCPCS:28285)

The enumeration date for this NPI number is 5/22/2006 and was last updated on 1/31/2022.

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
1213ES0103XPodiatristFoot & Ankle SurgeryP166IDAHONo
2213ES0103XPodiatristFoot & Ankle SurgeryP92IDAHONo
3213ES0103XPodiatristFoot & Ankle SurgeryP153IDAHONo
4332B00000XDurable Medical Equipment & Medical SuppliesNo
5261QA1903XClinic/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
103913OTHERIDAHOBLUE CROSS
2805730900MEDICAIDIDAHO
3P00091636OTHERIDAHORAILROAD MEDICARE
4000010027108OTHERIDAHOBLUE SHIELD
5807288200MEDICAIDIDAHO

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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