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SURGICARE CENTER OF IDAHO, LLC
NPI 1114923471
Clinic/Center - Ambulatory Surgical in Boise, ID

Active since June 22, 2005CLIA 13D1019855 · Waiver
360 E MALLARD DR, STE 125, BOISE, ID 83706(208) 336-8700(208) 426-0902 Get Directions Write a Review

NPPES record last updated: October 10, 2016. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Surgicare Center Of Idaho, Llc NPPES

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

SURGICARE CENTER OF IDAHO, LLC (NPI 1114923471) is a healthcare organization registered as an ambulatory surgical in Boise, Idaho and active in the NPI registry since June 2005. The organization holds a CLIA Waiver certificate valid through December 1, 2027 and lists Louis Pennow, Director, as its authorized official.

NPPES Registry Identity

NPI1114923471
Entity TypeOrganization
Primary Taxonomy261QA1903X
Legal Business NameSURGICARE CENTER OF IDAHO, LLC
Location Address360 E MALLARD DR, STE 125Boise, ID 83706-3941
Mailing Address360 E Mallard Dr, Ste 125Boise, ID 83706-6644 · (208) 336-8700 · Fax (208) 426-0902
Phone(208) 336-8700
Fax(208) 426-0902
Organization SubpartNo
Authorized OfficialLouis PennowDirector · (208) 336-8700
Enumeration DateJune 22, 2005
Last NPPES UpdateOctober 10, 2016
✔ NPI 1114923471 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyClinic/Center · Ambulatory SurgicalAmbulatory Health Care Facilities
Taxonomy Code261QA1903X
Also ListedClinic/Center · Ophthalmologic SurgeryTaxonomy 261QS0132X
360 E MALLARD DR, Boise, ID 83706
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Other Identifiers 3

Medicare ID-Type Unspecified1870391ID · Medicare
Medicare PIN490004468ID
Medicaid273390ID

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Moda Health Plan, Inc., PacificSource Health Plans, Providence Health Plan.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 13D1019855

Surgicare Center Of Idaho · Boise, ID
Active · expires Dec 1, 2027
CLIA Number13D1019855
Laboratory TypeAmbulatory Surgery Center
Certificate Effective DateDecember 2, 2025
Certificate Expiration DateDecember 1, 2027
Laboratory DirectorRyan T. Barrett
Laboratory Phone(208) 386-8700
Laboratory LocationSurgicare Center Of Idaho360 E Mallard Dr, Boise, ID 83706
CLIA data matches this NPI record on: Address Name
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 cataract with insertion of prosthetic lens 66984
This is a procedure where a cloudy lens in your eye, known as a cataract, is removed. After removal, a clear artificial lens is inserted. This helps to restore your vision, enabling you to see clearly again.
924 services580 patients
Removal of recurring cataract in lens capsule using a laser 66821
This procedure, known as YAG laser capsulotomy, treats cloudiness in the lens capsule following cataract surgery. A laser is used to create a small hole in the cloudy capsule, allowing light to pass through and restore clear vision. It's a quick, painless procedure.
490 services344 patients
Complex removal of cataract with insertion of prosthetic lens 66982
This procedure involves removing a cloudy lens (cataract) from your eye and replacing it with a clear, artificial lens. It helps restore vision that has been affected by the cataract. The operation is usually done under local anesthesia.
84 services65 patients
Laser repair to improve eye fluid flow 65855
Laser repair to improve eye fluid flow is a procedure aimed at treating glaucoma. A laser is used to create a small hole in the eye's drainage system, allowing fluid to flow out more easily. This helps to lower the pressure inside the eye, reducing the risk of vision loss.
74 services48 patients
Extracapsular removal of cataract with insertion of artificial lens and insertion of drainage device in front chamber of eye 66991
This is a two-part eye procedure. First, a cloudy lens (cataract) is removed from its outer layer and replaced with an artificial lens to improve vision. Second, a drainage device is inserted into the front part of the eye to manage fluid levels, preventing pressure build-up.
69 services45 patients
Phenylephrine 10.16 mg/ml and ketorolac 2.88 mg/ml ophthalmic irrigation solution, 1 ml J1097
This solution is used during eye surgery to maintain pupil dilation and reduce inflammation. Phenylephrine widens the pupil, while Ketorolac helps to prevent pain and swelling. It's applied directly to the eye by your healthcare provider during the procedure.
68 services16 patients

Other Providers at the Same Location NPPES 6

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

LINDA M EVANS CRNA
Nurse Anesthetist, Certified Registered
360 E MALLARD DR, SUITE 125
BOISE, ID 83706
Ada County (208) 336-8700
MRS. CHRISTI ALISE CAMPBELL RN
Registered Nurse (Ophthalmic)
360 E MALLARD DR, #110
BOISE, ID 83706
Ada County (208) 386-3306
MARK E HOLLINGSHEAD M.D.
Ophthalmology
360 E MALLARD DR, STE 110
BOISE, ID 83706
Ada County (208) 336-8700
BRIAN J MCNEEL O.D.
Optometrist
360 E MALLARD DR, STE 110
BOISE, ID 83706
Ada County (208) 336-8700
HOLLINGSHEAD EYE CENTER, PC
Ophthalmology
360 E MALLARD DR, SUITE 110
BOISE, ID 83706
Ada County (208) 336-8700
RYAN THOMAS BARRETT MD
Ophthalmology
360 E MALLARD DR, STE 110
BOISE, ID 83706
Ada County (208) 336-8700

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 Surgicare Center Of Idaho, LLC's NPI number?

The NPI number for Surgicare Center Of Idaho, LLC is 1114923471. It was assigned to this organization in the NPPES registry on June 22, 2005.

Where is Surgicare Center Of Idaho, LLC located?

Surgicare Center Of Idaho, LLC is located at 360 E Mallard Dr Ste 125, Boise, ID 83706. The listed phone number is (208) 336-8700.

What is Surgicare Center Of Idaho, LLC's specialty?

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

Does Surgicare Center Of Idaho, LLC hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 13D1019855) is associated with this NPI, valid through December 1, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

What insurance does Surgicare Center Of Idaho, LLC accept?

Health plans from Moda Health Plan, Inc., PacificSource Health Plans and Providence Health Plan list Surgicare Center Of Idaho, LLC 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 Surgicare Center Of Idaho, LLC was last updated on October 10, 2016. NPI Profile syncs with the weekly NPPES data releases published by CMS.