PCS PROCEDURE SUITE LLC
NPI 1659029411
Clinic/Center - Ambulatory Surgical in Pocatello, ID

Q: What is Pcs Procedure Suite LLC's NPI number?

The NPI number for Pcs Procedure Suite LLC is 1659029411. It was assigned to this organization in the NPPES registry on March 11, 2022.

Q: What is Pcs Procedure Suite LLC's specialty?

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

Active since March 11, 2022CLIA 13D1026192 · Waiver

110 VISTA DR, POCATELLO, ID 83201(208) 234-2300(208) 234-0026 Get Directions Write a Review

NPPES record last updated: September 28, 2023. Verified against the NPPES registry weekly; last sync: October 25, 2026.

On this page

About Pcs Procedure Suite Llc NPPES

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

PCS PROCEDURE SUITE LLC (NPI 1659029411) is a healthcare organization registered as an ambulatory surgical in Pocatello, Idaho and active in the NPI registry since March 2022. The organization holds a CLIA Waiver certificate valid through May 27, 2028 and lists Mark L Mansfield, Owner, as its authorized official.

NPPES Registry Identity

NPI1659029411

Entity TypeOrganization

Primary Taxonomy261QA1903X

Legal Business NamePCS PROCEDURE SUITE LLC

Location Address110 VISTA DRPocatello, ID 83201-5824

Mailing Address110 Vista DrPocatello, ID 83201-5824 · (208) 234-2300 · Fax (208) 234-0026

Phone(208) 234-2300

Fax(208) 234-0026

Organization SubpartNo

Authorized OfficialMark L MansfieldOwner · (208) 234-2300

Enumeration DateMarch 11, 2022

Last NPPES UpdateSeptember 28, 2023

NPPES CertifiedSeptember 28, 2023

✔ NPI 1659029411 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyClinic/Center · Ambulatory SurgicalAmbulatory Health Care Facilities

Taxonomy Code261QA1903X

110 VISTA DR, Pocatello, ID 83201

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Accepted Insurance

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

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Pcs Procedure Suite Llc 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 Pcs Procedure Suite LLC, which bills Medicare for the services this clinician delivers.

Clinician (1)

Richard Maynard, D.O.

Family Practice

NPI 1952395063

110 VISTA DR
Pocatello, ID 83201

(208) 234-2300

✔ PECOS✔ Accepts Medicare0.1 mi

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 13D1026192

Pcs Procedure Suite LLC · Pocatello, ID

Active · expires May 27, 2028

CLIA Number13D1026192

Laboratory TypeAmbulatory Surgery Center

Certificate Effective DateMay 28, 2026

Certificate Expiration DateMay 27, 2028

Laboratory DirectorMark L. Mansfield

Laboratory Phone(208) 234-2300

Laboratory LocationPcs Procedure Suite LLC110 Vista Dr, Pocatello, ID 83201

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 3

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.

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.

21 services21 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.

19 services19 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.

11 services11 patients

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 Pcs Procedure Suite LLC's NPI number?

The NPI number for Pcs Procedure Suite LLC is 1659029411. It was assigned to this organization in the NPPES registry on March 11, 2022.

Where is Pcs Procedure Suite LLC located?

Pcs Procedure Suite LLC is located at 110 Vista Dr, Pocatello, ID 83201. The listed phone number is (208) 234-2300.

What is Pcs Procedure Suite LLC's specialty?

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

Is Pcs Procedure Suite LLC enrolled in Medicare?

Yes. Pcs Procedure Suite LLC is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Pcs Procedure Suite LLC?

According to the CMS Revalidation Reassignment List (October 2026 release), 1 clinician (Family Practice) reassigns their Medicare billing to Pcs Procedure Suite LLC. 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 Pcs Procedure Suite LLC hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 13D1026192) is associated with this NPI, valid through May 27, 2028. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

What insurance does Pcs Procedure Suite LLC accept?

Health plans from PacificSource Health Plans, Providence Health Plan and Select Health list Pcs Procedure Suite 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 Pcs Procedure Suite LLC was last updated on September 28, 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.