North Idaho Day Surgery LLC
Organization Active NPI Multi-Specialty Clinic/Center · St Maries, ID
NPI 1093674301 · NPPES record last updated Mar 5, 2026
Key facts
- NPI
- 1093674301
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Multi-Specialty Clinic/Center 261QM1300X
- Legal business name
- NORTH IDAHO DAY SURGERY LLC
- Practice address
- 622 W College Ave Ste 2
St Maries, ID 83861-1822 - Phone
- (208) 568-7800
- Fax
- (877) 902-7131
- NPI assigned
- Jan 21, 2026
- Organization subpart
- No
Authorized official
- Name
- Jason Bell
- Title
- Payer Enrollment Specialist
- Phone
- (208) 618-2559
Owners & managing parties with NPI records 2
Other NPIs on the same Medicare enrollment 2
Corporate family (same tax ID) 10
Affiliated clinicians 385
-
Jessica A Adams, PA-C
-
Jonathan T Adams, P.A.-C
-
Marissa Armstrong, DNP, FNP-C
-
Katelin Nicole Arnold, DNP, APRN, FNP-C
-
Chad Daniel Bailey, ARNP
-
Andrea Marie Balsimo, FNP
-
Matthew C. Bean, MD
-
Jordan Bell, CRNA
-
Leah Bennett, NP
-
Eric Paul Benson, MD
-
Rebecca Joy Bertsch, D.O.
-
Angela Lynn Blake, DNP
-
Douglas Blaty, D.O.
-
Tanya Sue Blaty, DO
-
Joan M Bloom, M.D.
Medicare Care Compare: Hospital
- Listed as
- Northwest Specialty Hospital
- Type
- Acute Care Hospitals
- Ownership
- Proprietary
- Medicare certification status
- Active
- Emergency services
- No
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in ID
Hospital certification: CCN 130066
- Legal name
- NORTH IDAHO DAY SURGERY LLC
- Doing business as
- NORTHWEST SPECIALTY HOSPITAL
- Certification status
- Active
- Provider type (POS)
- Hospital – Short-term
- Participating since
- Oct 16, 2003
- Last certification
- Feb 6, 2026
- Beds
- 34
- Ownership / control type
- Private (for profit)
- Organization structure
- LLC · Proprietary
- Incorporated
- Dec 12, 2001 in ID
- Enrollment address
- 1593 E Polston Ave
Post Falls, ID 83854-5326 - Hospital subgroups
- Specialty hospital
All disclosed owners & managing parties 19
| Name | Role | Since | Share |
|---|---|---|---|
| SP Holdco I Inc |
5% Or Greater Indirect Ownership Interest | May 16, 2021 | 67.35% |
| National Surgical Hospitals, LLC |
5% Or Greater Indirect Ownership Interest | May 16, 2021 | 57.9% |
| Sgry Holdings, LP |
5% Or Greater Indirect Ownership Interest | May 26, 2021 | 9.45% |
| Jennifer B Baldock |
Corporate Officer |
Sep 1, 2017 | |
| FMR LLC |
5% Or Greater Indirect Ownership Interest | Nov 21, 2022 | 8.89% |
| SP Management Services Inc |
Operational/Managerial Control | Sep 17, 2020 | 100% |
| Bcpe Seminole Holdings, LP |
5% Or Greater Indirect Ownership Interest | May 16, 2021 | 20.21% |
| Sgry, LLC |
5% Or Greater Indirect Ownership Interest | May 26, 2021 | 9.45% |
| Rick S Rasmussen |
Corporate Officer |
Jul 1, 2012 | |
| W-2 Managing Employee |
Jul 1, 2012 | ||
| Surgery Partners Inc |
5% Or Greater Indirect Ownership Interest | Sep 17, 2020 | 67.35% |
| Mountain View Hospital LLC |
5% Or Greater Indirect Ownership Interest | Sep 17, 2020 | 13.63% |
| Surgery Center Holdings Inc |
5% Or Greater Indirect Ownership Interest | Sep 17, 2020 | 67.35% |
| NSH North Idaho, LLC |
5% Or Greater Direct Ownership Interest | Sep 17, 2020 | 57.9% |
| MVH NWSH LLC |
5% Or Greater Direct Ownership Interest | Sep 17, 2020 | 13.63% |
| Harrison R Bane |
Other |
Sep 1, 2024 | |
| Symbion Holdings LLC |
5% Or Greater Indirect Ownership Interest | May 26, 2021 | 9.45% |
| Smbi Idaho LLC |
5% Or Greater Indirect Ownership Interest | May 26, 2021 | 9.45% |
| Roger C Dunteman |
5% Or Greater Direct Ownership Interest | Sep 17, 2020 | 7% |
| Surgery Center Holdings LLC |
5% Or Greater Indirect Ownership Interest | Sep 17, 2020 | 67.35% |
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20030826000037 | ID | Part a Provider - Hospital | 0840101218 |
2 other NPIs on this enrollment This NPI is an additional NPI on the enrollment Practice locations: Saint Maries, ID; Rathdrum, ID; Post Falls, ID; Kellogg, ID; Coeur D Alene, ID; Athol, ID |
National Provider Directory
- Tax ID family
- North Idaho Day Surgery LLC
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Multi-Specialty Clinic/Center | 261QM1300X | Yes |
Addresses
Primary practice location
622 W College Ave Ste 2
St Maries, ID 83861-1822
Mailing address
1593 E Polston Ave
Post Falls, ID 83854-5326
Phone (208) 262-2300
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1104824739 | Medicaid | ID |
Other providers in St Maries, ID
- Christopher Milne
- Ashley W Milner
- Mistala Miller Counseling PLLC
- Kelsey Taylor Morris
- Rebekah G Myers
- Tim John Lee Ochoa
- Panhandle Eye Clinics Chartered
- Paradigm Hearing Center, LLC
- Seth Patzer
- Josie J Phillips
All providers in St Maries, ID · Multi-Specialty Clinic/Center in Idaho
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 5, 2026. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- CMS facility enrollments, All Owners and change-of-ownership files: CCNs, owners and managing parties.
- Provider of Services files (CMS): certification status, beds and related CCNs.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.