THE SHOULDER CLINIC OF IDAHO PLLC
NPI 1821164138
Orthopaedic Surgery in Boise, ID
About The Shoulder Clinic Of Idaho Pllc NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
THE SHOULDER CLINIC OF IDAHO PLLC (NPI 1821164138) is a healthcare organization registered as an orthopaedic surgery in Boise, Idaho and active in the NPI registry since November 2006. The organization lists Thomas Earl Goodwin, Owner, as its authorized official.
NPPES Registry Identity
Specialties & Licenses
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)
The Shoulder Clinic Of Idaho Pllc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Medicare Revalidation Due Date
Revalidation due by December 31, 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.
Clinicians Billing Medicare Through This Organization
3Medicare enrollment records show 3 clinicians reassign Medicare billing to The Shoulder Clinic Of Idaho PLLC, which bills Medicare for the services they deliver. Of these, 3 practice at this address. They are listed nearest first.
Clinicians, nearest first (3)
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
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 The Shoulder Clinic Of Idaho PLLC's NPI number?
The NPI number for The Shoulder Clinic Of Idaho PLLC is 1821164138. It was assigned to this organization in the NPPES registry on November 28, 2006.
Where is The Shoulder Clinic Of Idaho PLLC located?
The Shoulder Clinic Of Idaho PLLC is located at 8854 W Emerald St Ste 102, Boise, ID 83704. The listed phone number is (208) 323-4747.
What is The Shoulder Clinic Of Idaho PLLC's specialty?
The primary specialty registered for this NPI is Orthopaedic Surgery with taxonomy code 207X00000X.
Is The Shoulder Clinic Of Idaho PLLC enrolled in Medicare?
Yes. The Shoulder Clinic Of Idaho PLLC is registered in the Medicare PECOS enrollment system.
When is The Shoulder Clinic Of Idaho 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, Clinic/Group Practice) is due for revalidation by December 31, 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.
How many clinicians bill Medicare through The Shoulder Clinic Of Idaho PLLC?
According to the CMS Revalidation Reassignment List (October 2026 release), 3 clinicians, all in Orthopedic Surgery, reassign their Medicare billing to The Shoulder Clinic Of Idaho 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. Of these, 3 practice at this address. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
What insurance does The Shoulder Clinic Of Idaho PLLC accept?
Health plans from Moda Health Plan, Inc. and Molina Healthcare list The Shoulder Clinic Of Idaho 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 The Shoulder Clinic Of Idaho PLLC was last updated on March 14, 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.
# The Shoulder Clinic Of Idaho Pllc · NPI 1821164138
Orthopaedic Surgery organization in Boise, Idaho. Organization record, active in the CMS NPPES registry since November 28, 2006.
## Identity
- **NPI:** 1821164138 (Entity type: Organization)
- **Enumerated:** November 28, 2006
- **Primary specialty:** Orthopaedic Surgery · taxonomy 207X00000X
- **Organization subpart:** No
- **Authorized official:** Thomas Goodwin, OWNER
## Practice location
- **Address:** 8854 W EMERALD ST, STE 102, Boise, ID 83704-4844
- **Phone:** (208) 323-4747 · **Fax:** (208) 323-4848
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Medicare revalidation due:** December 31, 2026 (Non-DME Part B, Idaho, Clinic/Group Practice) · CMS Revalidation Due Date List, October 2026 release
- **Clinicians billing through this organization:** 3 clinicians (Orthopedic Surgery) reassign Medicare billing to this organization (form CMS-855R); 3 practice at this address · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** March 14, 2023
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Source: [NPI Profile](https://npiprofile.com/npi/1821164138) · Data from the CMS NPPES public registry.