IDAHO SKIN SURGERY CENTER, PC
NPI 1295908127
Dermatology in Boise, ID
About Idaho Skin Surgery Center, Pc NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
IDAHO SKIN SURGERY CENTER, PC (NPI 1295908127) is a healthcare organization registered as a dermatology in Boise, Idaho and active in the NPI registry since April 2008. The organization holds a CLIA Certificate of Compliance certificate valid through June 1, 2027 and lists Jared Scott, President, as its authorized official.
NPPES Registry Identity
Specialties & Licenses 3
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)
Idaho Skin Surgery Center, Pc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Medicare Revalidation Due Date
Revalidation due by January 31, 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 Idaho Skin Surgery Center, PC, 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 of Compliance 13D1084633
Idaho Skin Surgery Center · Boise, 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 Idaho Skin Surgery Center, PC's NPI number?
The NPI number for Idaho Skin Surgery Center, PC is 1295908127. It was assigned to this organization in the NPPES registry on April 11, 2008.
Where is Idaho Skin Surgery Center, PC located?
Idaho Skin Surgery Center, PC is located at 1906 S Vista Ave, Boise, ID 83705. The listed phone number is (208) 433-1114.
What is Idaho Skin Surgery Center, PC's specialty?
The primary specialty registered for this NPI is Dermatology with taxonomy code 207N00000X.
Is Idaho Skin Surgery Center, PC enrolled in Medicare?
Yes. Idaho Skin Surgery Center, PC is registered in the Medicare PECOS enrollment system.
When is Idaho Skin Surgery Center, PC'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 January 31, 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 Idaho Skin Surgery Center, PC?
According to the CMS Revalidation Reassignment List (October 2026 release), 2 clinicians reassign their Medicare billing to Idaho Skin Surgery Center, PC, in Dermatology 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 Idaho Skin Surgery Center, PC hold a CLIA laboratory certificate?
Yes. A Certificate of Compliance (number 13D1084633) is associated with this NPI, valid through June 1, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.
What insurance does Idaho Skin Surgery Center, PC accept?
Health plans from Moda Health Plan, Inc. list Idaho Skin Surgery Center, PC 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 Idaho Skin Surgery Center, PC was last updated on December 12, 2014. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 11 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.
# Idaho Skin Surgery Center, Pc · NPI 1295908127
Dermatology organization in Boise, Idaho. Organization record, active in the CMS NPPES registry since April 11, 2008.
## Identity
- **NPI:** 1295908127 (Entity type: Organization)
- **Enumerated:** April 11, 2008
- **Primary specialty:** Dermatology · taxonomy 207N00000X
- **Organization subpart:** No
- **Authorized official:** Jared Scott, PRESIDENT
## Practice location
- **Address:** 1906 S VISTA AVE, Boise, ID 83705-3453
- **Phone:** (208) 433-1114 · **Fax:** (208) 433-1115
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Medicare revalidation due:** January 31, 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: Dermatology (1), Nurse Practitioner (1); 1 practice at this address · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** December 12, 2014
- **CLIA laboratory certificates:** 1 on file
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Source: [NPI Profile](https://npiprofile.com/npi/1295908127) · Data from the CMS NPPES public registry.