DOCTORS CLINIC OF ELMORE COUNTY PLLC
NPI 1063578664
Family Medicine in Mountain Home, ID
About Doctors Clinic Of Elmore County Pllc NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
DOCTORS CLINIC OF ELMORE COUNTY PLLC (NPI 1063578664) is a healthcare organization registered as a family medicine in Mountain Home, Idaho and active in the NPI registry since December 2006. The organization holds a CLIA Microscopy certificate valid through July 9, 2027 and lists Layne D Roberts, Physician, as its authorized official.
NPPES Registry Identity
Specialties & Licenses 2
Other Identifiers 2
Group Practice 1
Accepted Insurance
Medicare Participation & PECOS CMS
Medicare enrollment, revalidation and the clinicians who bill Medicare through this organization, from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Doctors Clinic Of Elmore County Pllc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Medicare Revalidation Due Date
Revalidation due by February 28, 2027
Medicare-enrolled providers and suppliers confirm their enrollment information with CMS on a set cycle, every 5 years for most and every 3 years for medical equipment suppliers. CMS sets the due date for each enrollment.
Clinicians Billing Medicare Through This Organization
2Medicare enrollment records show 2 clinicians reassign Medicare billing to Doctors Clinic Of Elmore County PLLC, which bills Medicare for the services they deliver. Of these, 1 practice at this address. They are listed nearest first.
Clinicians, nearest first (2)
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
CLIA Laboratory Certificates CMS CLIA
Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.
Certificate for Provider-Performed Microscopy Procedures (PPMP) 13D0938420
Doctors Clinic Of Elmore County · Mountain Home, IDFrequently 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 Doctors Clinic Of Elmore County PLLC's NPI number?
The NPI number for Doctors Clinic Of Elmore County PLLC is 1063578664. It was assigned to this organization in the NPPES registry on December 28, 2006.
Where is Doctors Clinic Of Elmore County PLLC located?
Doctors Clinic Of Elmore County PLLC is located at 2000 American Legion Blvd, Mountain Home, ID 83647. The listed phone number is (208) 587-1500.
What is Doctors Clinic Of Elmore County PLLC's specialty?
The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.
Is Doctors Clinic Of Elmore County PLLC enrolled in Medicare?
Yes. Doctors Clinic Of Elmore County PLLC is registered in the Medicare PECOS enrollment system.
When is Doctors Clinic Of Elmore County PLLC's Medicare revalidation due?
According to the CMS Revalidation Due Date List (October 2026 release), the Medicare Non-DME Part B enrollment for this organization (Idaho, Clinic/Group Practice) is due for revalidation by February 28, 2027. Medicare providers and suppliers revalidate their enrollment every 5 years, and medical equipment suppliers every 3 years. Confirm current requirements with your Medicare Administrative Contractor.
How many clinicians bill Medicare through Doctors Clinic Of Elmore County PLLC?
According to the CMS Revalidation Reassignment List (October 2026 release), 2 clinicians reassign their Medicare billing to Doctors Clinic Of Elmore County PLLC, in Family Practice and Nurse Practitioner. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. Of these, 1 practice at this address. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Does Doctors Clinic Of Elmore County PLLC hold a CLIA laboratory certificate?
Yes. A Certificate for Provider-Performed Microscopy Procedures (PPMP) (number 13D0938420) is associated with this NPI, valid through July 9, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.
What insurance does Doctors Clinic Of Elmore County PLLC accept?
Health plans from Moda Health Plan, Inc. list Doctors Clinic Of Elmore County PLLC as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.
When was this NPI record last updated?
The NPPES record for Doctors Clinic Of Elmore County PLLC was last updated on February 25, 2008. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 18 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.
# Doctors Clinic Of Elmore County Pllc · NPI 1063578664
Family Medicine organization in Mountain Home, Idaho. Organization record, active in the CMS NPPES registry since December 28, 2006.
## Identity
- **NPI:** 1063578664 (Entity type: Organization)
- **Enumerated:** December 28, 2006
- **Primary specialty:** Family Medicine · taxonomy 207Q00000X
- **Organization subpart:** No
- **Authorized official:** Layne Roberts, PHYSICIAN
## Practice location
- **Address:** 2000 AMERICAN LEGION BLVD, Mountain Home, ID 83647-3138
- **Phone:** (208) 587-1500 · **Fax:** (208) 587-3180
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Medicare revalidation due:** February 28, 2027 (Non-DME Part B, Idaho, Clinic/Group Practice) · CMS Revalidation Due Date List, October 2026 release
- **Clinicians billing through this organization:** 2 clinicians in 2 Medicare specialties reassign Medicare billing to this organization (form CMS-855R); largest: Family Practice (1), Nurse Practitioner (1); 1 practice at this address · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** February 25, 2008
- **Other identifiers:** Medicare UPIN D17306 (ID); Medicare ID-Type Unspecified 1378082 (ID)
- **CLIA laboratory certificates:** 1 on file
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Source: [NPI Profile](https://npiprofile.com/npi/1063578664) · Data from the CMS NPPES public registry.