Idaho Otologic Surgery Center, LLC

Primary specialty

Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X

Legal business name

IDAHO OTOLOGIC SURGERY CENTER, LLC

Practice address

1209 N Summerbrook Ave Ste 110
Meridian, ID 83642-8760

Phone

(208) 938-5823

Fax

(208) 963-3270

NPI assigned

May 27, 2021

Organization subpart

No

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

Authorized official

Name

James Crawford, MDNPI 1215904966

Title

Owner

Phone

(253) 278-4304

Specialties & licenses 1

Addresses

Other names 1

• Syringa Outpatient Surgery Center Doing business as

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in ID

Enrollment records 1

Listed as

Idaho Otologic Surgery Center LLC Dba Syringa Outpatient Surgery CenterCCN 13C0001091

Medicare certification status

ActiveFrom the Provider of Services file

Locations

Practitioners 2

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

• James Vincent Crawford, MD

  • Otology & Neurotology Physician
  • Meridian, ID
  • NPI 1215904966
  NPD Authorized official
• Eric Peter Wilkinson, MD

  • Otolaryngology Physician
  • Meridian, ID
  • NPI 1114906013
  NPD

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

{
    "created_epoch": "1622073600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1665014400000",
    "number": "1972179208",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13900 W WAINWRIGHT DR STE 102",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837135028",
            "telephone_number": "480-455-2769",
            "fax_number": "208-963-3270"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1209 N SUMMERBROOK AVE STE 110",
            "city": "MERIDIAN",
            "state": "ID",
            "postal_code": "836428760",
            "telephone_number": "208-938-5823",
            "fax_number": "208-963-3270"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "IDAHO OTOLOGIC SURGERY CENTER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-05-27",
        "last_updated": "2022-10-06",
        "certification_date": "2022-10-06",
        "status": "A",
        "authorized_official_last_name": "CRAWFORD",
        "authorized_official_first_name": "JAMES",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "253-278-4304",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "eClinicalWorks",
            "affiliation": "N",
            "endpointDescription": "EHR System",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "address_1": "1209 N Summerbrook Ave Ste 100",
            "city": "Meridian",
            "state": "ID",
            "country_code": "US",
            "postal_code": "836428750",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Syringa Outpatient Surgery Center",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Syringa Outpatient Surgery Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Ambulatory Surgical Clinic/Center in Meridian, ID
• Providers in Meridian, 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 Oct 6, 2022; 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.