Skyline Surgery Center, LLC

Primary specialty

Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X

Legal business name

SKYLINE SURGERY CENTER, LLC

Practice address

285 Vista Dr
Ste C
Pocatello, ID 83201

Phone

(208) 478-1704

Fax

(208) 233-6970

NPI assigned

Jun 17, 2008

Organization subpart

No

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

Authorized official

Name

Kathryn Buckalew

Title

Administrator

Phone

(208) 785-3877

Specialties & licenses 1

Addresses

Other names 1

• Skyline Surgery Center Inc Former legal business name

Medicare fee-for-service enrollment

Enrolled in ID2 enrollments

Enrollment records 2

Listed as

Skyline Surgery Center LLCCCN 13C0001065

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

Medicare medical equipment & supply locations

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

• Mountain River Birthing and Surgery Center LLC

  • General Acute Care Hospital
  • Blackfoot, ID
  • NPI 1851371959

  Member Of

  NPD member

Practitioners 3

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

• Ryan Don Hope, M.D.

  • Addiction Medicine (Anesthesiology) Physician
  • Pocatello, ID
  • NPI 1881897932
  NPD
• Daniel M Huff, M.D.

  • Anesthesiology Physician
  • Pocatello, ID
  • NPI 1891743944
  NPD
• Benjamin J Allen, MD

  • Orthopaedic Surgery Physician
  • Rochester, MN
  • NPI 1750692752
  NPD (past)

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

{
    "created_epoch": "1213660800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1527724800000",
    "number": "1851552483",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "285 VISTA DRIVE",
            "address_2": "SUITE C",
            "city": "POCATELLO",
            "state": "ID",
            "postal_code": "83201",
            "telephone_number": "208-478-1704",
            "fax_number": "208-233-6970"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "285 VISTA DR",
            "address_2": "STE C",
            "city": "POCATELLO",
            "state": "ID",
            "postal_code": "83201",
            "telephone_number": "208-478-1704",
            "fax_number": "208-233-6970"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SKYLINE SURGERY CENTER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-06-17",
        "last_updated": "2018-05-31",
        "status": "A",
        "authorized_official_last_name": "BUCKALEW",
        "authorized_official_first_name": "KATHRYN",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "208-785-3877"
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Skyline Surgery Center Inc",
            "code": "4",
            "type": "Former Legal Business Name"
        },
        {
            "organization_name": "Skyline Surgery Center Inc",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

• Brooke Lee Skinner, PHYSICIAN ASSISTANT
• Tylee Skinner, OTR/L
• Brandon Skoumal
• Steve M Skoumal, MD
• Darya Skrenes, MD
• Taylor R Slade
• Slate Medical Aesthetics PLLC
• William C. Slaven, LCSW, CADC
• Jeffrey Slavich, P.A.
• Chayla Eve Slavin

• Ambulatory Surgical Clinic/Center in Pocatello, ID
• Providers in Pocatello, 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 May 31, 2018; 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.