Organization Active NPI

Minimally Invasive Surgery Northwest PA

  • Surgery Physician
  • Post Falls, ID
National Provider Identifier
1942459698
Registry record updated Jul 23, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
Legal business name
MINIMALLY INVASIVE SURGERY NORTHWEST PA
Practice address
750 N Syringa St
Suite 103
Post Falls, ID 83854-5275
Phone
(208) 415-0151
Fax
(208) 416-4146
NPI assigned
Sep 17, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 23, 2014

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

Authorized official

Name
Antoine Sarkis, MDNPI 1235182213
Title
Physician
Phone
(208) 415-0151

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
Surgery PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208600000X Primary

Addresses

Primary practice location

750 N Syringa St
Suite 103
Post Falls, ID 83854-5275

Mailing address

750 N Syringa St
Suite 103
Post Falls, ID 83854-5275
Phone (208) 415-0151

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040209001221 ID Part B Supplier - Clinic/Group Practice 8224922596 Receives reassigned benefits from 2 practitioners
Practice locations: Post Falls, ID

National Provider Directory

National Provider Directory

Locations

750 N Syringa St
Ste 103
Post Falls, ID 83854
Phone (208) 415-0151

Practitioners & affiliated clinicians

Practitioners 2

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": "1221609600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1406073600000",
    "number": "1942459698",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "750 N SYRINGA ST",
            "address_2": "SUITE 103",
            "city": "POST FALLS",
            "state": "ID",
            "postal_code": "838545275",
            "telephone_number": "208-415-0151",
            "fax_number": "208-416-4146"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "750 N SYRINGA ST",
            "address_2": "SUITE 103",
            "city": "POST FALLS",
            "state": "ID",
            "postal_code": "838545275",
            "telephone_number": "208-415-0151",
            "fax_number": "208-416-4146"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MINIMALLY INVASIVE SURGERY NORTHWEST PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-09-17",
        "last_updated": "2014-07-23",
        "status": "A",
        "authorized_official_last_name": "SARKIS",
        "authorized_official_first_name": "ANTOINE",
        "authorized_official_title_or_position": "PHYSICIAN",
        "authorized_official_telephone_number": "208-415-0151",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Post Falls, ID

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 23, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.