BOISE ENDOSCOPY CENTER LLC
NPI 1114912102
Clinic/Center - Ambulatory Surgical in Boise, ID

Q: What is Boise Endoscopy Center LLC's NPI number?

The NPI number for Boise Endoscopy Center LLC is 1114912102. It was assigned to this organization in the NPPES registry on September 15, 2005.

Q: What is Boise Endoscopy Center LLC's specialty?

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

Active since September 15, 2005CLIA 13D0521568 · Waiver

425 W BANNOCK ST, BOISE, ID 83702(208) 342-7169(208) 368-0863 Get Directions Write a Review

NPPES record last updated: April 18, 2026. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Apr 18, 2026, Dec 8, 2022, Jul 22, 2019 (3 updates tracked since 2019).

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About Boise Endoscopy Center Llc NPPES

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

BOISE ENDOSCOPY CENTER LLC (NPI 1114912102) is a healthcare organization registered as an ambulatory surgical in Boise, Idaho and active in the NPI registry since September 2005. The organization holds a CLIA Waiver certificate valid through December 9, 2027 and lists Robert Lockwood, Authorized Official, as its authorized official.

NPPES Registry Identity

NPI1114912102

Entity TypeOrganization

Primary Taxonomy261QA1903X

Legal Business NameBOISE ENDOSCOPY CENTER LLC

Location Address425 W BANNOCK STBoise, ID 83702-6035

Mailing Address425 W Bannock StBoise, ID 83702-6035 · (208) 342-7169 · Fax (208) 343-5031

Phone(208) 342-7169

Fax(208) 368-0863

Organization SubpartNo

Authorized OfficialRobert LockwoodAuthorized Official · (208) 342-7169

Enumeration DateSeptember 15, 2005

Last NPPES UpdateApril 18, 20263 updates tracked since enumeration

NPPES CertifiedApril 18, 2026

✔ NPI 1114912102 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 · 1870273

425 W BANNOCK ST, Boise, ID 83702

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Other Identifiers 3

Other000010005291ID · Blue Shield Of Idaho

Other04580ID · Blue Cross Of Idaho

Medicaid805944300ID

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Moda Health Plan, Inc., PacificSource Health Plans.Insurance ›

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 of Waiver 13D0521568

Boise Endoscopy Center LLC · Boise, ID

Active · expires Dec 9, 2027

CLIA Number13D0521568

Laboratory TypeAmbulatory Surgery Center

Certificate Effective DateDecember 10, 2025

Certificate Expiration DateDecember 9, 2027

Laboratory DirectorRobert A. Lockwood

Laboratory Phone(208) 342-7169

Laboratory LocationBoise Endoscopy Center LLC425 W Bannock St, Boise, ID 83702

CLIA data matches this NPI record on: Address Name Phone

This certificate is issued to a laboratory to perform only waived tests.

Areas of Expertise CMS Part B claims 10

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Removal of polyps or growths of large bowel using an endoscope with mechanical snare 45385

This procedure involves using a thin, flexible tube called an endoscope to examine the large bowel. If any abnormal growths or polyps are found, a tool called a mechanical snare is used to remove them. This is a common method to prevent potential health issues.

376 services373 patients

Biopsy of esophagus, stomach, and/or upper small bowel using a flexible endoscope 43239

This procedure involves using a thin, flexible tube with a light and camera, known as an endoscope, to examine the esophagus, stomach, and upper part of the small intestine. Small tissue samples are taken for further examination to help diagnose various conditions.

262 services255 patients

Biopsy of large bowel using a flexible endoscope 45380

A biopsy of the large bowel using a flexible endoscope is a procedure where a thin, flexible tube with a camera is inserted through the rectum to examine the bowel. If abnormal tissue is found, a small sample is taken for further examination. This helps in diagnosing conditions like inflammation, polyps, or cancer.

151 services150 patients

Insertion of guide wire with dilation of esophagus using a flexible endoscope 43248

This is a procedure where a thin tube, called an endoscope, is gently passed through your mouth into your esophagus. A guide wire is then inserted to help widen any narrow areas. This helps improve swallowing and reduce discomfort.

116 services114 patients

Colorectal cancer screening; colonoscopy on individual at high risk G0105

Colorectal cancer screening, specifically a colonoscopy, is a preventive measure for those at high risk. A thin, flexible tube with a camera inspects the colon to spot any abnormal growths. This test helps detect potential issues early, enhancing the effectiveness of treatment.

84 services84 patients

Colorectal cancer screening; colonoscopy on individual not meeting criteria for high risk G0121

Colorectal cancer screening, such as a colonoscopy, is a preventive measure to detect early signs of cancer in the large intestine. For individuals not at high risk, it's typically recommended at age 50. A small, flexible tube with a camera is used to examine your colon. It's a safe, effective way to catch issues early.

48 services48 patients

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Other Providers at the Same Location NPPES 20

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

LAURA LELA HARTWIG FNP-C

Nurse Practitioner (Family)