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HIGH VALLEY DERMATOLOGY & DERMATOLOGIC SURGERY PLLC
NPI 1063840288
Dermatology - MOHS-Micrographic Surgery in Idaho Falls, ID

Active since October 25, 2013CLIA Certified · 4 labs
2085 PROVIDENCE WAY, IDAHO FALLS, ID 83404(208) 525-4888 Get Directions Write a Review

NPPES record last updated: April 13, 2026. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About High Valley Dermatology & Dermatologic Surgery Pllc NPPES

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

HIGH VALLEY DERMATOLOGY & DERMATOLOGIC SURGERY PLLC (NPI 1063840288) is a healthcare organization registered as a mohs-micrographic surgery in Idaho Falls, Idaho and active in the NPI registry since October 2013. The organization holds 4 active CLIA laboratory certificates and lists Brandon Miner, Office Manager, as its authorized official.

NPPES Registry Identity

NPI1063840288
Entity TypeOrganization
Primary Taxonomy207ND0101X
Legal Business NameHIGH VALLEY DERMATOLOGY & DERMATOLOGIC SURGERY PLLC
Location Address2085 PROVIDENCE WAYIdaho Falls, ID 83404-4945
Mailing Address2085 Providence WayIdaho Falls, ID 83404-4945
Phone(208) 525-4888
Organization SubpartNo
Authorized OfficialBrandon MinerOffice Manager · (208) 525-4888
Enumeration DateOctober 25, 2013
Last NPPES UpdateApril 13, 2026
NPPES CertifiedApril 13, 2026
✔ NPI 1063840288 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDermatology · MOHS-Micrographic SurgeryAllopathic & Osteopathic Physicians
Taxonomy Code207ND0101X
License✔ Licensed in ID · O-0568
Definition
The highly-trained surgeons that perform Mohs Micrographic Surgery are specialists both in dermatology and pathology. With their extensive knowledge of the skin and unique pathological skills, they are able to remove only diseased tissue, preserving healthy tissue and minimizing the cosmetic impact of the surgery. Mohs surgeons who belong to the American College of Mohs Surgery (ACMS) have completed a minimum of one year of fellowship training at one of the ACMS-approved training centers in the U.S.
2085 PROVIDENCE WAY, Idaho Falls, ID 83404
Open in Google Maps ↗

Other Identifiers 1

Other1528279189Npi

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

CLIA Laboratory Certificates CMS CLIA 4

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 of Compliance 13D0927132

High Valley Dermatology And Dermatologic Surgery PLLC · Idaho Falls, ID
Active · expires Dec 1, 2027
CLIA Number13D0927132
Laboratory TypePhysician Office
Certificate Effective DateDecember 2, 2025
Certificate Expiration DateDecember 1, 2027
Laboratory DirectorBrandon L. Miner
Laboratory Phone(208) 535-4888
Laboratory LocationHigh Valley Dermatology And Dermatologic Surgery PLLC2085 Providence Way, Idaho Falls, ID 83404
CLIA data matches this NPI record on: Address
This certificate is issued to a laboratory after an inspection that finds the laboratory to be in compliance with all applicable CLIA requirements.

Certificate of Waiver 53D2295011

High Valley Dermatology & Dermatologic Surgery Pll · Alpine, WY
Active · expires Dec 3, 2027
CLIA Number53D2295011
Laboratory TypePhysician Office
Certificate Effective DateDecember 4, 2025
Certificate Expiration DateDecember 3, 2027
Laboratory DirectorBrandon L. Miner
Laboratory Phone(208) 525-4888
Laboratory LocationHigh Valley Dermatology & Dermatologic Surgery Pll37 Wintergreen, Alpine, WY 83128
CLIA data matches this NPI record on: Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Certificate of Compliance 13D0917694

High Valley Dermatology And Dermatologic Surgery PLLC · Rigby, ID
Active · expires Apr 6, 2028
CLIA Number13D0917694
Laboratory TypePhysician Office
Certificate Effective DateApril 7, 2026
Certificate Expiration DateApril 6, 2028
Laboratory DirectorBrandon L. Miner
Laboratory Phone(208) 525-4888
Laboratory LocationHigh Valley Dermatology And Dermatologic Surgery PLLC703 Rigby Lake Dr, Rigby, ID 83442
CLIA data matches this NPI record on: Phone
This certificate is issued to a laboratory after an inspection that finds the laboratory to be in compliance with all applicable CLIA requirements.

Certificate of Compliance 13D2295000

High Valley Dermatology And Dermatologic Surgery · Idaho Falls, ID
Active · expires Mar 30, 2027
CLIA Number13D2295000
Laboratory TypePhysician Office
Certificate Effective DateMarch 31, 2025
Certificate Expiration DateMarch 30, 2027
Laboratory DirectorBrandon L. Miner
Laboratory Phone(208) 525-4888
Laboratory LocationHigh Valley Dermatology And Dermatologic Surgery925 S Utah Ave, Idaho Falls, ID 83402
CLIA data matches this NPI record on: Phone
This certificate is issued to a laboratory after an inspection that finds the laboratory to be in compliance with all applicable CLIA requirements.

Other Providers at the Same Location NPPES 3

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

DR. LINDSAY D. SEWELL M.D.
Dermatology
2085 PROVIDENCE WAY
IDAHO FALLS, ID 83404
Bonneville County (208) 525-4888
BRANDON LYNN MINER D.O
Dermatology (MOHS-Micrographic Surgery)
2085 PROVIDENCE WAY
IDAHO FALLS, ID 83404
Bonneville County (208) 525-4888
HIGH VALLEY DERMATOLOGY & DERMATOLOGIC SURGERY PLLC
Dermatology (MOHS-Micrographic Surgery)
2085 PROVIDENCE WAY
IDAHO FALLS, ID 83404
Bonneville County (208) 525-4888

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 High Valley Dermatology & Dermatologic Surgery PLLC's NPI number?

The NPI number for High Valley Dermatology & Dermatologic Surgery PLLC is 1063840288. It was assigned to this organization in the NPPES registry on October 25, 2013.

Where is High Valley Dermatology & Dermatologic Surgery PLLC located?

High Valley Dermatology & Dermatologic Surgery PLLC is located at 2085 Providence Way, Idaho Falls, ID 83404. The listed phone number is (208) 525-4888.

What is High Valley Dermatology & Dermatologic Surgery PLLC's specialty?

The primary specialty registered for this NPI is Dermatology, specializing in MOHS-Micrographic Surgery, with taxonomy code 207ND0101X.

Does High Valley Dermatology & Dermatologic Surgery PLLC hold CLIA laboratory certificates?

Yes. 4 active CLIA laboratory certificates are associated with this NPI under the federal Clinical Laboratory Improvement Amendments program. The certificates are listed in the CLIA Laboratory Certificates section above.

When was this NPI record last updated?

The NPPES record for High Valley Dermatology & Dermatologic Surgery PLLC was last updated on April 13, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 months 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.