NPIMap

Organization Active NPI

River City Surgical Center

  • Ambulatory Surgical Clinic/Center
  • Boise, ID
National Provider Identifier
1558733147
Registry record updated Aug 22, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X
Legal business name
RIVER CITY SURGICAL CENTER
Practice address
10118 W Overland Rd
Boise, ID 83709-1428
Phone
(208) 887-2233
NPI assigned
Oct 22, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2016

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

Authorized official

Name
Roy Rogers, D.D.S.NPI 1235170044
Title
Member
Phone
(208) 376-8873

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ambulatory Surgical Clinic/Center 261QA1903X Primary

Addresses

Primary practice location

10118 W Overland Rd
Boise, ID 83709-1428

Mailing address

PO Box 44163
Boise, ID 83711-0163
Phone (208) 887-2233

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ID

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20160406002274 ID Part B Supplier - Ambulatory Surgical Center 3173821253 Receives reassigned benefits from 1 practitioner
Practice locations: Boise, ID

Ambulatory surgical center certification: CCN 13C0001078

Name & address match This certification has no NPI in the Medicare enrollment files. CMS publishes enrollment files for six facility types only, so it was connected to this NPI by matching the name and address CMS publishes for it.

Legal name
RIVER CITY SURGICAL CENTER
Certification status
Active
Provider type (POS)
Ambulatory surgical center
Participating since
Sep 27, 2016
Last certification
Sep 27, 2016
Ownership / control type
Proprietary
Facility address
10118 W Overland Road
Boise, ID 83709

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1445472000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1471824000000",
    "number": "1558733147",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 44163",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837110163",
            "telephone_number": "208-887-2233"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10118 W OVERLAND RD",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837091428",
            "telephone_number": "208-887-2233"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RIVER CITY SURGICAL CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-10-22",
        "last_updated": "2016-08-22",
        "status": "A",
        "authorized_official_last_name": "ROGERS",
        "authorized_official_first_name": "ROY",
        "authorized_official_title_or_position": "MEMBER",
        "authorized_official_telephone_number": "208-376-8873",
        "authorized_official_credential": "D.D.S."
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boise, ID

Sources for this page

Verify at the official NPI Registry.