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SOUTHERN IDAHO SURGERY CENTER PLLC
NPI 1396069902
Clinic/Center - Ambulatory Surgical in Meridian, ID

Active since March 25, 2010CLIA 13D2106536 · Waiver
3235 N TOWERBRIDGE WAY STE 100, MERIDIAN, ID 83646(208) 895-6611 Get Directions Write a Review

NPPES record last updated: July 9, 2012. Verified against the NPPES registry weekly; last sync: October 18, 2026.

About Southern Idaho Surgery Center Pllc NPPES

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

SOUTHERN IDAHO SURGERY CENTER PLLC (NPI 1396069902) is a healthcare organization registered as an ambulatory surgical in Meridian, Idaho and active in the NPI registry since March 2010. The organization holds a CLIA Waiver certificate valid through December 20, 2027 and lists Marlon B Michel, President, as its authorized official.

NPPES Registry Identity

NPI1396069902
Entity TypeOrganization
Primary Taxonomy261QA1903X
Legal Business NameSOUTHERN IDAHO SURGERY CENTER PLLC
Location Address3235 N TOWERBRIDGE WAY STE 100Meridian, ID 83646-5721
Mailing Address3235 N Towerbridge Way Ste 100Meridian, ID 83646-5721 · (208) 895-6611
Phone(208) 895-6611
Organization SubpartNo
Authorized OfficialMarlon B MichelPresident · (208) 895-6611
Enumeration DateMarch 25, 2010
Last NPPES UpdateJuly 9, 2012
✔ NPI 1396069902 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyClinic/Center · Ambulatory SurgicalAmbulatory Health Care Facilities
Taxonomy Code261QA1903X
3235 N TOWERBRIDGE WAY STE 100, Meridian, ID 83646
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Accepted Insurance

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

Medicare Participation & PECOS CMS

Medicare enrollment and revalidation status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Southern Idaho Surgery Center Pllc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Medicare Revalidation Due Date

Revalidation due by November 30, 2026

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.

StateEnrollment IDDue date
StateIdahoEnrollment IDO20110527000154Non-DME Part B · Ambulatory Surgical CenterDue dateNovember 30, 2026
Source: CMS Revalidation Due Date List, October 2026 release.

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 13D2106536

Southern Idaho Surgery Center · Meridian, ID
Active · expires Dec 20, 2027
CLIA Number13D2106536
Laboratory TypeAmbulatory Surgery Center
Certificate Effective DateDecember 21, 2025
Certificate Expiration DateDecember 20, 2027
Laboratory DirectorMarlon B. Michel
Laboratory Phone(208) 895-6611
Laboratory LocationSouthern Idaho Surgery Center3235 N Towerbridge Way #100, Meridian, ID 83646
CLIA data matches this NPI record on: Name Phone
This certificate is issued to a laboratory to perform only waived tests.

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.

SISC ANESTHESIA INC
Nurse Anesthetist, Certified Registered
3235 N TOWERBRIDGE WAY STE 100
MERIDIAN, ID 83646
Ada County (208) 895-1908
NASKER ANESTHESIA, INCORPORATED
Nurse Anesthetist, Certified Registered
3235 N TOWERBRIDGE WAY STE 100
MERIDIAN, ID 83646
Ada County (208) 895-1908
DAVID ALLEN CRNA
Nurse Anesthetist, Certified Registered
3235 N TOWERBRIDGE WAY STE 100
MERIDIAN, ID 83646
Ada County (208) 895-6611

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 Southern Idaho Surgery Center PLLC's NPI number?

The NPI number for Southern Idaho Surgery Center PLLC is 1396069902. It was assigned to this organization in the NPPES registry on March 25, 2010.

Where is Southern Idaho Surgery Center PLLC located?

Southern Idaho Surgery Center PLLC is located at 3235 N Towerbridge Way Ste 100, Meridian, ID 83646. The listed phone number is (208) 895-6611.

What is Southern Idaho Surgery Center PLLC's specialty?

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

Is Southern Idaho Surgery Center PLLC enrolled in Medicare?

Yes. Southern Idaho Surgery Center PLLC is registered in the Medicare PECOS enrollment system.

When is Southern Idaho Surgery Center 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, Ambulatory Surgical Center) is due for revalidation by November 30, 2026. 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.

Does Southern Idaho Surgery Center PLLC hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 13D2106536) is associated with this NPI, valid through December 20, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

What insurance does Southern Idaho Surgery Center PLLC accept?

Health plans from Moda Health Plan, Inc. and PacificSource Health Plans list Southern Idaho Surgery Center 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 Southern Idaho Surgery Center PLLC was last updated on July 9, 2012. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 14 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.