SKYLINE SURGERY CENTER, LLC
NPI 1851552483
Clinic/Center - Ambulatory Surgical in Pocatello, ID

NPI Status: Active since June 17, 2008

Contact Information

285 VISTA DR
STE C
POCATELLO, ID
ZIP 83201
Phone: (208) 478-1704
Fax: (208) 233-6970

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  • Organization
  • Clinic/Center
  • Ambulatory Surgical
  • Accepts Insurance
  • Medicare Supplier
  • Accepts Medicare Approved Payment
  • CLIA Number: 13D2053554
  • CLIA Cert. Type: Ambulatory Surgery Center
  • CLIA Exp. Date: 02-03-2027

About SKYLINE SURGERY CENTER, LLC

This page provides the complete NPI Profile along with additional information for Skyline Surgery Center, Llc, a provider established in Pocatello, Idaho operating as a Clinic/center, focusing in ambulatory surgical . The healthcare provider is registered in the NPI registry with number 1851552483 assigned on June 2008. The practitioner's primary taxonomy code is 261QA1903X. The provider is registered as an organization and their NPI record was last updated 8 years ago. The provider's former legal business name is Skyline Surgery Center Inc. The authorized official of this NPI record is Kathryn Buckalew (Administrator)

NPI
1851552483
Provider Legal Name
SKYLINE SURGERY CENTER, LLC
Other Organization Name
SKYLINE SURGERY CENTER INC
Other Name Type
Former Legal Business Name (4)
Entity Type
Organization
Location Address
285 VISTA DR STE C POCATELLO, ID 83201
Location Phone
(208) 478-1704
Location Fax
(208) 233-6970
Mailing Address
285 VISTA DRIVE SUITE C POCATELLO, ID 83201
Mailing Phone
(208) 478-1704
Mailing Fax
(208) 233-6970
Is Sole Proprietor?
No
Is Organization Subpart?
No
Enumeration Date
06-17-2008
Last Update Date
05-31-2018
Code Navigator



Skyline Surgery Center, Llc is a medicare supplier with PTAN 26716516 who accepts Medicare assignment for all durable medical equipment and supplies. The provider accepts the Medicare allowable as payment in full.The supplier carries the following product categories: Breast Prostheses and/or Accessories or Neurostimulators and/or Supplies or Prosthetic Lenses: Prosthetics Cataract Lenses.

Location Map

Specialty - Primary Taxonomy

The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Classification

Clinic/Center Ambulatory Surgical

Taxonomy Code
261QA1903X
Type
Ambulatory Health Care Facilities

Insurance Plans Accepted

According to publicly available information the provider might be accepting the following health plans from these health insurance companies:

  • Moda Select Alaska Bronze 6500 - PPO
  • Moda Select Alaska Bronze HDHP 5500 - PPO
  • Moda Select Alaska Gold 1500 - PPO
  • Moda Select Alaska Silver 4500 - PPO
  • Moda Select Alaska Standard Bronze - PPO
  • Moda Select Alaska Standard Gold - PPO
  • Moda Select Alaska Standard Silver - PPO
  • Moda Select Texas Bronze 8700 ($0 Virtual Urgent Care through CirrusMD) - EPO
  • Moda Select Texas Bronze HDHP 7500 - EPO
  • Moda Select Texas Standard Bronze - EPO
  • Moda Select Texas Standard Gold - EPO
  • Moda Select Texas Standard Silver - EPO
  • Core Bronze HSA 10600 - EPO
  • Core Bronze HSA 7500 - EPO
  • Core Bronze HSA 8300 - EPO
  • Core Gold 1500 - EPO
  • Core Gold 3000 - EPO
  • Core Silver 3500 - EPO
  • Core Silver 4500 - EPO
  • Core Silver 5000 - EPO
  • Core Silver 7500 - EPO
  • Core Standard Expanded Bronze HSA - EPO
  • Core Standard Gold - EPO
  • Core Standard Silver - EPO
  • PacificSource Oregon Standard Bronze HSA Plan Core - EPO
  • PacificSource Oregon Standard Gold Plan Core - EPO
  • PacificSource Oregon Standard Silver Plan Core - EPO
  • HSA Qualified 7500 Bronze - Choice Network - EPO
  • HSA-E Qualified 7500 Bronze - Signature Network - EPO
  • Providence Oregon Standard Bronze Plan - Choice Network - EPO
  • Providence Oregon Standard Bronze Plan - Signature Network - EPO
  • Providence Oregon Standard Gold Plan - Choice Network - EPO
  • Providence Oregon Standard Gold Plan - Signature Network - EPO
  • Providence Oregon Standard Silver Plan - Choice Network - EPO
  • Providence Oregon Standard Silver Plan - Signature Network - EPO
  • Healthy Premier Bronze HSA - EPO
  • Healthy Premier Expanded Bronze Standard - EPO
  • Healthy Premier Gold Copay Office Visits - EPO
  • Healthy Premier Gold Standard - EPO
  • Healthy Premier Silver Copay Office Visits - EPO
  • Healthy Premier Silver Standard - EPO

*Please verify directly with this provider to make sure your insurance plan is currently accepted.

Authorized Official

The authorized official is the designated individual with the legal authority to make changes to the provider’s official NPI record. For organizations, the authorized official must be a general partner, chairman of the board, CEO, CFO or a direct owner holding at least a 5 percent stake in the medical organization.

Authorized Official Name

KATHRYN BUCKALEW

Authorized Official Title
ADMINISTRATOR
Authorized Official Phone
(208) 785-3877

Areas of Expertise

The following services and procedures, recently provided to Medicare patients, illustrate the range of care this provider offers. This list reflects the variety of services available to all patients visiting the practice and is based on 2022 Medicare dataset. In general, the more frequently a provider treats specific conditions or performs particular procedures, the more experienced they become in addressing similar patient needs. The provider has delivered many of the services listed below to Medicare patients. Please note that this list does not include services provided to patients who are not covered by Medicare.

Aspiration and/or injection of fluid from large joint

This procedure involves using a needle to remove (aspiration) or introduce (injection) fluid into a large joint like the knee or hip. It can help diagnose conditions, relieve discomfort, or deliver medication directly to the joint.

This service was performed 191 times for 67 patients

Biopsy of esophagus, stomach, and/or upper small bowel using a flexible endoscope

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.

This service was performed 52 times for 51 patients

Biopsy of large bowel using a flexible endoscope

A biopsy of the large bowel using a flexible endoscope is a procedure where a thin, flexible tube with a camera is inserted through the rectum to examine the bowel. If abnormal tissue is found, a small sample is taken for further examination. This helps in diagnosing conditions like inflammation, polyps, or cancer.

This service was performed 26 times for 26 patients

Colorectal cancer screening; colonoscopy on individual not meeting criteria for high risk

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.

This service was performed 17 times for 17 patients

Destruction of lower or sacral spinal facet joint nerves using imaging guidance, single facet joint

This procedure involves using imaging guidance to accurately target and destroy nerves in the lower or sacral spinal facet joint. It's done to relieve chronic back pain. The process is safe and usually effective.

This service was performed 123 times for 50 patients

Destruction of upper or middle spinal facet joint nerves using imaging guidance, single facet joint

This procedure involves the use of imaging technology to guide a needle to the nerves of a single facet joint in the upper or middle spine. The nerves are then treated to alleviate pain and improve mobility.

This service was performed 24 times for 11 patients

Diagnostic exam of large bowel using a flexible endoscope

This procedure, known as a colonoscopy, involves using a flexible tube with a light and camera to examine the large intestine. It helps detect any abnormalities such as polyps or inflammation. It's a standard procedure to ensure gut health.

This service was performed 22 times for 22 patients

Incision of tendon covering of finger

This procedure involves making a small cut into the protective sheath around a finger tendon. It's typically done to relieve pressure or inflammation, improve finger movement, or treat conditions like trigger finger. It's a safe, often outpatient procedure.

This service was performed 45 times for 32 patients

Injection of substance into lower spine canal using imaging guidance

This procedure involves injecting a substance into your lower spine canal, guided by real-time images. It's done to diagnose or treat various conditions. You may feel slight discomfort, but it's generally safe and can provide valuable information for your treatment plan.

This service was performed 42 times for 32 patients

Injection of substance into middle or upper spine canal using imaging guidance

This procedure involves injecting a substance into your middle or upper spine canal. It's performed under imaging guidance to ensure accuracy. The substance can help diagnose or treat various conditions, providing relief from symptoms.

This service was performed 31 times for 22 patients

Injection procedure for sacroiliac joint; provision of anesthetic, steroid and/or other therapeutic agent, with or without arthrography

This procedure involves injecting medicine into the sacroiliac joint, located in the lower back. The aim is to reduce inflammation and pain. Anesthetic is used for immediate pain relief, while a steroid helps decrease inflammation over time. Arthrography, a type of imaging, may be used for precision.

This service was performed 183 times for 74 patients

Insertion of guide wire with dilation of esophagus using a flexible endoscope

This is a procedure where a thin tube, called an endoscope, is gently passed through your mouth into your esophagus. A guide wire is then inserted to help widen any narrow areas. This helps improve swallowing and reduce discomfort.

This service was performed 23 times for 21 patients

Release and/or relocation of elbow nerve

This procedure involves adjusting the position of a nerve in your elbow to alleviate discomfort or improve function. The nerve is carefully moved from its original location and placed in a less strained position. This can help reduce pain and improve arm movement.

This service was performed 20 times for 19 patients

Release and/or relocation of hand nerve

This procedure involves adjusting or moving a nerve in your hand to alleviate discomfort or improve function. The nerve may be compressed, causing pain or numbness. By releasing or relocating the nerve, these symptoms can be reduced, enhancing hand usage.

This service was performed 41 times for 36 patients

Release of wrist ligament using an endoscope

This procedure involves using a small camera, called an endoscope, to view and treat a tight wrist ligament. The endoscope is inserted through a tiny incision, reducing recovery time and scarring. It helps to relieve pain and improve wrist function.

This service was performed 20 times for 19 patients

Removal of cataract with insertion of prosthetic lens

This is a procedure where a cloudy lens in your eye, known as a cataract, is removed. After removal, a clear artificial lens is inserted. This helps to restore your vision, enabling you to see clearly again.

This service was performed 192 times for 121 patients

Removal of polyps or growths of large bowel using an endoscope with mechanical snare

This procedure involves using a thin, flexible tube called an endoscope to examine the large bowel. If any abnormal growths or polyps are found, a tool called a mechanical snare is used to remove them. This is a common method to prevent potential health issues.

This service was performed 17 times for 17 patients

Removal of recurring cataract in lens capsule using a laser

This procedure, known as YAG laser capsulotomy, treats cloudiness in the lens capsule following cataract surgery. A laser is used to create a small hole in the cloudy capsule, allowing light to pass through and restore clear vision. It's a quick, painless procedure.

This service was performed 66 times for 51 patients

Medical Equipment Supplier

The provider carries the following medical supplies product categories:

PTAN
26716516
Accepts Medicare Assignment
YES
Provider Type List
AMBULATORY SURGICAL CENTER.
Competitive Bidding
NO

Supplies List

  • Breast Prostheses and/or Accessories - Prosthetic bra, Surgical bra
  • Neurostimulators and/or Supplies - Rechargable neurostimulators, Non-rechargable neurostimulators
  • Prosthetic Lenses: Prosthetics Cataract Lenses - Cataract Eyeglasses

CLIA Information

The Clinical Laboratory Improvement Amendments (CLIA) of 1988 applies to facilities or sites that test human specimens for health assessment or to diagnose, prevent, or treat disease. The CLIA Program sets standards for clinical laboratory testing and issues certificates. The NPI / CLIA crosswalk information for this NPI number is:

CLIA Number
13D2053554
Facility Type
Ambulatory Surgery Center
Certificate Effective Date
February 04, 2025
Certificate Expiration Date
February 03, 2027
Laboratory Director
DEB MEYER
Certificate Type
Certificate of Waiver
Certificate Type Description
This CLIA certificate is issued to Skyline Surgery Center, Llc to perform only waived tests. CLIA defines waived tests as simple tests with a low risk for an incorrect result. Waived tests include certain tests listed in CLIA regulations, tests cleared by the FDA for home use and tests approved by the FDA for waived status and that meet CLIA waiver criteria.

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NPI NPI Number Validation

How NPI Validation Works

The NPI validation process uses the ISO-standard Luhn algorithm, a mathematical "handshake", to ensure that a provider's 10-digit ID is authentic and free of common typing errors.

To verify the NPI 1851552483, we treat the final digit (3) as the Check Digit—the target answer we need to reach. The process begins by taking the first nine digits and adding a constant value of 24, which accounts for the "80840" prefix required for all U.S. health identifiers. We then double every other digit starting from the right and sum the individual digits of those results together. For this specific NPI, that total comes to 57. The final step is to find the difference between that total and the next multiple of ten (60 - 57 = 3).

Digit-by-digit view

Use the first nine digits for the calculation. Starting from the right, double every other digit. The last digit is the check digit and is not part of the calculation.

Pos 1
1
Doubled → 2
Pos 2
8
Unchanged
Pos 3
5
Doubled → 10 → 1 + 0
Pos 4
1
Unchanged
Pos 5
5
Doubled → 10 → 1 + 0
Pos 6
5
Unchanged
Pos 7
2
Doubled → 4
Pos 8
4
Unchanged
Pos 9
8
Doubled → 16 → 1 + 6
Check
3
Target digit
Regular digit Doubled digit Check digit

Step 1: Double every other digit from the right

Starting with the rightmost digit of the first nine digits, double every other value. If doubling creates a two-digit number, add those digits together.

1 → 2 5 → 10 → 1 5 → 10 → 1 2 → 4 8 → 16 → 7

Step 2: Add all digits plus the NPI constant

Add the transformed values, the unchanged digits, and the constant 24.

2 + 8 + 1 + 0 + 1 + 1 + 0 + 5 + 4 + 4 + 1 + 6 + 24 = 57

Step 3: Find the amount needed to reach the next multiple of 10

The next multiple of ten after 57 is 60. The difference is the calculated check digit.

60 - 57 = 3
This NPI is valid
The calculated check digit is 3, which matches the last digit of 1851552483.

Other Providers at the Same Location


The following 13 providers are registered at the same or a nearby location.

Pain Medicine (Interventional Pain Medicine)
285 VISTA DR
POCATELLO, ID 83201
Psychiatry & Neurology (Psychiatry)
285 VISTA DR, SUITE D
POCATELLO, ID 83201
Physical Therapist
285 VISTA DR, SUITE A
POCATELLO, ID 83201
Plastic Surgery (Surgery of the Hand)
285 VISTA DR
POCATELLO, ID 83201
Nurse Anesthetist, Certified Registered
285 VISTA DR
POCATELLO, ID 83201
Nurse Anesthetist, Certified Registered
285 VISTA DR
POCATELLO, ID 83201
Nurse Anesthetist, Certified Registered
285 VISTA DR
POCATELLO, ID 83201
Nurse Anesthetist, Certified Registered
285 VISTA DR
POCATELLO, ID 83201
Pain Medicine (Interventional Pain Medicine)
285 VISTA DR, STE. E
POCATELLO, ID 83201
Anesthesiology
285 VISTA DR
POCATELLO, ID 83201
Nurse Anesthetist, Certified Registered
285 VISTA DR
POCATELLO, ID 83201
Physical Therapist
285 VISTA DR, SUITE A
POCATELLO, ID 83201
Nurse Anesthetist, Certified Registered
285 VISTA DR
POCATELLO, ID 83201

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1851552483, enumerated as an "organization" on June 17, 2008.

The provider is located at 285 VISTA DR STE C POCATELLO, ID 83201 and the phone number is (208) 478-1704.

Clinic/Center with taxonomy code 261QA1903X and a focus in Ambulatory Surgical.

The provider might be accepting Accepts: Moda Health Plan, Inc., PacificSource Health. Please consult your insurance carrier or call the provider to verify.