Idaho Surgicenter South - Medicare in Pocatello, ID

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.

Contact Information

Idaho Surgicenter South
1157 Call Place,
Pocatello, ID 83201
(208) 238-6337
(208) 776-5510



Healthcare Provider's Profile

Full NameIdaho Surgicenter South
TypeFacility
SpecialityClinic/center - Ambulatory Surgical
Location1157 Call Place, Pocatello, Idaho
Accepts Medicare AssignmentsMedicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs.
  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.
IdentifierTypeStateIssuer
1992759930NPI-NPPES
000010027108OtherIDBLUE SHIELD
805730900MedicaidID
P00091636OtherIDRAILROAD MEDICARE
03913OtherIDBLUE CROSS
807288200MedicaidID

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
213ES0103XPodiatrist - Foot & Ankle Surgery P166 (Idaho)Secondary
213ES0103XPodiatrist - Foot & Ankle Surgery P92 (Idaho)Secondary
213ES0103XPodiatrist - Foot & Ankle Surgery P153 (Idaho)Secondary
261QA1903XClinic/center - Ambulatory Surgical (* (Not Available))Primary
332B00000XDurable 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 AddressPractice 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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