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MOUNTAIN WEST MEDICAL SERVICES PLLC
NPI 1457894339
Clinic/Center - Primary Care in Meridian, ID

Active since November 28, 2016CLIA 13D2125343 · Waiver
1067 S WELLS ST, SUITE#110, MERIDIAN, ID 83642(208) 229-8739(208) 895-8540 Get Directions Write a Review

NPPES record last updated: July 7, 2023. Verified against the NPPES registry weekly; last sync: October 18, 2026.

Record update history: Jul 7, 2023, Jul 14, 2017 (2 updates tracked since 2017).

About Mountain West Medical Services Pllc NPPES

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

MOUNTAIN WEST MEDICAL SERVICES PLLC (NPI 1457894339) is a healthcare organization registered as a primary care in Meridian, Idaho and active in the NPI registry since November 2016. The organization holds a CLIA Waiver certificate valid through February 5, 2027 and lists John Kenneth Mcrae, Dr. Of Nurse Practioner, as its authorized official.

NPPES Registry Identity

NPI1457894339
Entity TypeOrganization
Primary Taxonomy261QP2300X
Legal Business NameMOUNTAIN WEST MEDICAL SERVICES PLLC
Location Address1067 S WELLS ST, SUITE#110Meridian, ID 83642-7997
Mailing Address1067 S Wells St, Suite#110Meridian, ID 83642-7997 · (208) 229-8739 · Fax (208) 895-8540
Phone(208) 229-8739
Fax(208) 895-8540
Organization SubpartNo
Authorized OfficialJohn Kenneth McraeDr. Of Nurse Practioner · (208) 229-8739
Enumeration DateNovember 28, 2016
Last NPPES UpdateJuly 7, 20232 updates tracked since enumeration
NPPES CertifiedJuly 7, 2023
✔ NPI 1457894339 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyClinic/Center · Primary CareAmbulatory Health Care Facilities
Taxonomy Code261QP2300X
License✔ Licensed in ID · 54169
1067 S WELLS ST, Meridian, ID 83642
Open in Google Maps ↗

Medicare Participation & PECOS CMS

Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Mountain West Medical Services Pllc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

Medicare enrollment records show 1 clinician reassigns Medicare billing to Mountain West Medical Services PLLC, which bills Medicare for the services this clinician delivers.

Clinician (1)

John Mcrae, DNP
Nurse Practitioner
NPI 1750838504
1067 S WELLS ST
Meridian, ID 83642
(208) 895-8486
✔ PECOS✔ Accepts MedicareSame address

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 Waiver 13D2125343

Mountain West Medical Services PLLC · Meridian, ID
Active · expires Feb 5, 2027
CLIA Number13D2125343
Laboratory TypePractitioner Other
Certificate Effective DateFebruary 6, 2025
Certificate Expiration DateFebruary 5, 2027
Laboratory DirectorJohn Mcrae
Laboratory Phone(208) 229-8739
Laboratory LocationMountain West Medical Services PLLC1067 S Wells St Ste 110, Meridian, ID 83642
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory to perform only waived tests.

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 Mountain West Medical Services PLLC's NPI number?

The NPI number for Mountain West Medical Services PLLC is 1457894339. It was assigned to this organization in the NPPES registry on November 28, 2016.

Where is Mountain West Medical Services PLLC located?

Mountain West Medical Services PLLC is located at 1067 S Wells St Suite#110, Meridian, ID 83642. The listed phone number is (208) 229-8739.

What is Mountain West Medical Services PLLC's specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Primary Care, with taxonomy code 261QP2300X.

Is Mountain West Medical Services PLLC enrolled in Medicare?

Yes. Mountain West Medical Services PLLC is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Mountain West Medical Services PLLC?

According to the CMS Revalidation Reassignment List (October 2026 release), 1 clinician (Nurse Practitioner) reassigns their Medicare billing to Mountain West Medical Services PLLC. 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. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Does Mountain West Medical Services PLLC hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 13D2125343) is associated with this NPI, valid through February 5, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Mountain West Medical Services PLLC was last updated on July 7, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 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.