Premier Surgical Center, Inc

Primary specialty

Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X

Legal business name

PREMIER SURGICAL CENTER, INC

Practice address

5680 W Gage St
Boise, ID 83706-1326

Phone

(208) 377-3937

Fax

(208) 377-9455

NPI assigned

Nov 29, 2005

Last updated

Oct 7, 2011By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

John Reed Sonntag, M.D.NPI 1245223809

Title

Medical Director

Phone

(208) 377-3937

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in ID

Enrollment records 1

Listed as

Premier Surgical Center IncCCN 13C0001052

Medicare certification status

ActiveFrom the Provider of Services file

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• John R Sonntag, M.D.

  • Ophthalmology Physician
  • Boise, ID
  • NPI 1245223809
  NPD Authorized official
• Jacob Adam Mong, D.O.

  • Ophthalmology Physician
  • Boise, ID
  • NPI 1346535481
  NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1133222400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1317945600000",
    "number": "1275516718",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5680 W GAGE ST",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837061326",
            "telephone_number": "208-377-3937",
            "fax_number": "208-377-9455"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5680 W GAGE ST",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837061326",
            "telephone_number": "208-377-3937",
            "fax_number": "208-377-9455"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PREMIER SURGICAL CENTER, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-11-29",
        "last_updated": "2011-10-07",
        "status": "A",
        "authorized_official_last_name": "SONNTAG",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "REED",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "208-377-3937",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Preferred Community Homes, LLC
• Marisa Preisler
• Tessa Prejeant
• Premier Health Systems PLLC
• Premier Physical Therapy Inc
• Premiere Case Management
• Premise Health of Colorado Medical, P.C. (Micron Family Health Center)
• Premium Support Services Inc
• Molly Vaughan Prengaman, APN, FNP-BC
• Robyn Prentice, LCSW

• Ambulatory Surgical Clinic/Center in Boise, ID
• Providers in Boise, ID by specialty
• Ambulatory Surgical Clinic/Center in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 7, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.