Pleasant View Surgery Center, LLC
Organization Active NPI Ambulatory Surgical Clinic/Center · Post Falls, ID
NPI 1669720397 · NPPES record last updated Oct 6, 2020
Key facts
- NPI
- 1669720397
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Ambulatory Surgical Clinic/Center 261QA1903X
- License
- W-113717 (ID)
- Legal business name
- PLEASANT VIEW SURGERY CENTER, LLC
- Practice address
- 4171 West Expo Parkway
Post Falls, ID 83854 - Phone
- (208) 262-3823
- NPI assigned
- Aug 28, 2012
- Organization subpart
- No
Authorized official
- Name
- Dr. Jeffrey Lyman, MD
- Title
- Ceo
- Phone
- (480) 203-0425
Practitioners 1
-
Joseph Marshall Bowen, M.D.
Medicare Care Compare: Ambulatory surgical center
- Listed as
- Pleasant View Surgery Center LLC
- Medicare certification status
- Active
Laboratory certificates & supplier records
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 13D2047069 | Pleasant View Surgery Center | Certificate of waiver | Sep 17, 2026 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in ID
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20130123000265 | ID | Part B Supplier - Ambulatory Surgical Center | 5193978229 | Practice locations: Post Falls, ID |
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Ambulatory Surgical Clinic/Center | 261QA1903X | W-113717 | ID | Yes |
Addresses
Primary practice location
4171 West Expo Parkway
Post Falls, ID 83854
Mailing address
4171 West Expo Parkway
Post Falls, ID 83854
Phone (208) 582-3793
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Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 6, 2020. 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.
- 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.