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IDAHO FALLS SURGICAL CENTER ASC
NPI 1053481218
Clinic/Center - Ambulatory Surgical in Idaho Falls, ID

Active since November 08, 2006
1945 E 17TH ST, IDAHO FALLS, ID 83404(208) 529-1945(208) 529-1961 Get Directions Write a Review

NPPES record last updated: June 9, 2008. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Idaho Falls Surgical Center Asc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

IDAHO FALLS SURGICAL CENTER ASC (NPI 1053481218) is a healthcare organization registered as an ambulatory surgical in Idaho Falls, Idaho and active in the NPI registry since November 2006. The organization lists Mark L Petersen, President, as its authorized official.

NPPES Registry Identity

NPI1053481218
Entity TypeOrganization
Primary Taxonomy261QA1903X
Legal Business NameIDAHO FALLS SURCIGAL CENTER
Location Address1945 E 17TH STIdaho Falls, ID 83404-6429
Mailing AddressPo Box 52180Idaho Falls, ID 83405-2180 · (208) 523-4906 · Fax (208) 523-2025
Phone(208) 529-1945
Fax(208) 529-1961
Organization SubpartNo
Authorized OfficialMark L PetersenPresident · (208) 529-1945
Enumeration DateNovember 8, 2006
Last NPPES UpdateJune 9, 2008
✔ NPI 1053481218 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyClinic/Center · Ambulatory SurgicalAmbulatory Health Care Facilities
Taxonomy Code261QA1903X
License✔ Licensed in ID · 13-C0001000
1945 E 17TH ST, Idaho Falls, ID 83404
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Other Names 1

Other NameIdaho Falls Surgical Center Asc

Other Identifiers 3

Medicaid002512900ID
Medicare PIN1870019ID
Other490000095Railroad Medicare

Other Providers at the Same Location NPPES 5

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

IDAHO FALLS SURGICAL CENTER
Anesthesiology
1945 E 17TH ST
IDAHO FALLS, ID 83404
Bonneville County (208) 529-1945
JON F CHAMPLIN CRNA
Nurse Anesthetist, Certified Registered
1945 E 17TH ST
IDAHO FALLS, ID 83404
Bonneville County (208) 529-1945
SURGERY CENTER ANESTHESIA PLLC
Anesthesiology
1945 E 17TH ST
IDAHO FALLS, ID 83404
Bonneville County (208) 529-1945
IDAHO FALLS SURGICAL CENTER
Durable Medical Equipment & Medical Supplies
1945 E 17TH ST
IDAHO FALLS, ID 83404
Bonneville County (208) 529-1945
IDAHO FALLS SURGICAL CENTER
Nurse Anesthetist, Certified Registered
1945 E 17TH ST
IDAHO FALLS, ID 83404
Bonneville County (208) 529-1945

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Idaho Falls Surcigal Center's NPI number?

The NPI number for Idaho Falls Surcigal Center is 1053481218. It was assigned to this organization in the NPPES registry on November 8, 2006. The provider is also known as Idaho Falls Surgical Center ASC.

Where is Idaho Falls Surcigal Center located?

Idaho Falls Surcigal Center is located at 1945 E 17th St, Idaho Falls, ID 83404. The listed phone number is (208) 529-1945.

What is Idaho Falls Surcigal Center's specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Ambulatory Surgical, with taxonomy code 261QA1903X.

When was this NPI record last updated?

The NPPES record for Idaho Falls Surcigal Center was last updated on June 9, 2008. NPI Profile syncs with the weekly NPPES data releases published by CMS.