Maple Grove Surgical LLC

Primary specialty

Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X

Legal business name

MAPLE GROVE SURGICAL LLC

Practice address

8955 W Hackamore Dr
Boise, ID 83709-1673

Phone

(208) 344-7944

NPI assigned

Aug 22, 2022

Last updated

Feb 2, 2024By 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

Matthew Neale, MDNPI 1184885345

Title

Medical Director

Phone

(204) 344-7944

Specialties & licenses 2

Addresses

Locations

Practitioners 1

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.

• Matthew D Neale, MD

  • Ophthalmology Physician
  • Boise, ID
  • NPI 1184885345
  Authorized official Same address or phone

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

{
    "created_epoch": "1661126400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1706832000000",
    "number": "1417675737",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8955 W HACKAMORE DR",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837091673",
            "telephone_number": "208-344-7944"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8955 W HACKAMORE DR",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837091673",
            "telephone_number": "208-344-7944"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MAPLE GROVE SURGICAL LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-08-22",
        "last_updated": "2024-02-02",
        "certification_date": "2024-02-02",
        "status": "A",
        "authorized_official_last_name": "NEALE",
        "authorized_official_first_name": "MATTHEW",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "204-344-7944",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QS0132X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ophthalmologic Surgery",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Savarra Marie Mantzor, M.D.
• Claryce Manweiler
• Kamille Eldene Ariel Manzo, LMSW
• Valer Mapendo, LMSW
• Maple Grove Eyecare PC
• Kelci Denae Mar, DPT
• Roberta Mendiola Maratita
• Marc Bostick MD Chartered
• Lesley March
• Elena Marchesan, LPC

• 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 Feb 2, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.