NPIMap

Organization Active NPI

Everest ASC

  • Ambulatory Surgical Clinic/Center
  • Meridian, ID
National Provider Identifier
1689349219
Registry record updated Apr 18, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X
Legal business name
EVEREST ASC
Practice address
2960 E St Lukes St
Meridian, ID 83642
Phone
(208) 378-4264
NPI assigned
Aug 16, 2021
Last updated
Apr 18, 2025By the provider in NPPES
Organization subpart
Yes
Parent organization
EVEREST SURGICAL INSTITUTEAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Apr 18, 2025

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

Authorized official

Name
Rosie Avila
Title
Director of Nursing
Phone
(702) 506-5887

Specialties & licenses 1

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

Addresses

Primary practice location

2960 E St Lukes St
Meridian, ID 83642

Mailing address

2960 East St Lukes St
Meridian, ID 83642
Phone (208) 992-4111

Other identifiers 1

IdentifierTypeStateIssuer
1184652364MedicaidID

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20220121000238 ID Part B Supplier - Ambulatory Surgical Center 0840682076 Practice locations: Meridian, ID

Care Compare: Ambulatory surgical center

Medicare Care Compare
Listed as
Everest ASCCCN 13C0001090
Medicare certification status
ActiveFrom the Provider of Services file

Laboratory certificates & supplier records

Derived by NPIMap

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

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
13D2235470Everest Ambulatory Surgery Center (ASC)2960 E St Lukes St, Meridian, ID 83642Certificate of waiverSep 8, 2027

National Provider Directory

National Provider Directory
Part of
Everest Surgical Institute

Locations

2960 E St Lukes St
ID 83642

2960 E St Lukes St
Meridian, ID 83642
Phone (208) 577-0225

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

Practitioners & affiliated clinicians

Practitioners 15

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.

View all 15

NPI Registry JSON

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

{
    "created_epoch": "1629072000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1744934400000",
    "number": "1689349219",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2960 EAST ST LUKES ST",
            "city": "MERIDIAN",
            "state": "ID",
            "postal_code": "83642",
            "telephone_number": "208-992-4111"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2960 E ST LUKES ST",
            "city": "MERIDIAN",
            "state": "ID",
            "postal_code": "83642",
            "telephone_number": "208-378-4264"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EVEREST ASC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "EVEREST SURGICAL INSTITUTE",
        "enumeration_date": "2021-08-16",
        "last_updated": "2025-04-18",
        "certification_date": "2025-04-18",
        "status": "A",
        "authorized_official_last_name": "AVILA",
        "authorized_official_first_name": "ROSIE",
        "authorized_official_title_or_position": "DIRECTOR OF NURSING",
        "authorized_official_telephone_number": "702-506-5887"
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1184652364",
            "state": "ID"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Meridian, ID

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 18, 2025; 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.