Idaho Surgicenter South is a medicare enrolled "Clinic/center - Ambulatory Surgical" provider in Pocatello, Idaho. Their current practice location is
1157 Call Place, Pocatello, Idaho. You can reach out to their office (for appointments etc.) via phone at
(208) 238-6337.
Idaho Surgicenter South is licensed to practice in * (Not Available) (license number ) and it also participates in the medicare program. Idaho Surgicenter South
is enrolled with medicare and should accept medicare assignments and since they are enrolled in medicare, they may order Medicare Part D Prescription drugs, if eligible. The facility's NPI Number is 1992759930.
Healthcare Provider's Profile
| Full Name | Idaho Surgicenter South |
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| Type | Facility |
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| Speciality | Clinic/center - Ambulatory Surgical |
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| Location | 1157 Call Place, Pocatello, Idaho |
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| Accepts Medicare Assignments | Medicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs. |
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NPI Data:
- NPI Number: 1992759930
- Provider Enumeration Date: 05/22/2006
- Last Update Date: 01/31/2022
Medicare PECOS Information:
- PECOS PAC ID: 7214071620
- Enrollment ID: O20100528000652
Medical Identifiers
Medical identifiers for Idaho Surgicenter South such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1992759930 | NPI | - | NPPES |
| 000010027108 | Other | ID | BLUE SHIELD |
| 805730900 | Medicaid | ID | |
| P00091636 | Other | ID | RAILROAD MEDICARE |
| 03913 | Other | ID | BLUE CROSS |
| 807288200 | Medicaid | ID | |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 213ES0103X | Podiatrist - Foot & Ankle Surgery | P166 (Idaho) | Secondary |
| 213ES0103X | Podiatrist - Foot & Ankle Surgery | P92 (Idaho) | Secondary |
| 213ES0103X | Podiatrist - Foot & Ankle Surgery | P153 (Idaho) | Secondary |
| 261QA1903X | Clinic/center - Ambulatory Surgical | (* (Not Available)) | Primary |
| 332B00000X | Durable Medical Equipment & Medical Supplies | (* (Not Available)) | Secondary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Idaho Surgicenter South is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
|---|
Idaho Surgicenter South
Po Box 2067,
Pocatello, ID 83206-2067
Ph: (208) 238-6337 | Idaho Surgicenter South
1157 Call Place,
Pocatello, ID 83201
Ph: (208) 238-6337 |
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