Henrys Fork Surgery Center PLLC
NPI 1235768490 · Ambulatory Surgical Clinic/Center · Rexburg, ID
Enrolled with Medicare as Part B Supplier - Ambulatory Surgical Center · source: CMS PECOS Public Provider Enrollment (2026.04.01)
Henrys Fork Surgery Center PLLC is a Ambulatory Surgical Clinic/Center organization in Rexburg, ID (NPI 1235768490).
Provider details
- NPI number
- 1235768490
- Entity type
- Organization
- Primary specialty
- Ambulatory Surgical Clinic/CenterAmbulatory Health Care Facilities
- Organization subpart
- No
- Authorized official
- Jeremy Johnson, Manager(208) 359-1888
Specialties & taxonomies
Ambulatory Health Care Facilities
Profile Score
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure28% of score
6 yrs in NPPES registry
- Profile completeness28% of score
100% of core fields populated
- Practice footprint17% of score
1 documented practice location
- Medicare service volume (vs. specialty peers)28% of score
489 Medicare services, 2024 (ranked within specialty)
Medicare volume is ranked against active providers in the same specialty. Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
What this provider does (Medicare)
Based on Medicare fee-for-service claims, 2024; not all care is captured.
| Service (HCPCS) | Medicare services | Typical Medicare-allowed (2024) |
|---|---|---|
| Removal of Cataract With Insertion of Prosthetic Lens66984 | 291 | $1,009 |
| Removal of Eye Fluid (vitreous) Between Lens and Retina67036 | 100 | $1,771 |
| Removal of Membrane of Retina67041 | 36 | $1,771 |
| Removal of Excessive Skin and Fat of Upper Eyelid15823 | 29 | $593 |
| Removal of Membrane of Retina With Removal of Internal Limiting Membrane of Retina67042 | 19 | $1,771 |
| Complex Removal of Cataract With Insertion of Prosthetic Lens66982 | 14 |
Practice location
Mailing address
Registry dates
- Enumerated
- 2020-04-08
- Last updated
- 2025-06-19
- Certified
- 2025-05-20
Frequently asked questions
- What is Henrys Fork Surgery Center PLLC's NPI number?
- Henrys Fork Surgery Center PLLC's National Provider Identifier (NPI) is 1235768490, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What type of organization is Henrys Fork Surgery Center PLLC?
- Henrys Fork Surgery Center PLLC is classified in the NPPES registry as Ambulatory Surgical Clinic/Center (Ambulatory Health Care Facilities).
- Where is Henrys Fork Surgery Center PLLC located?
- Henrys Fork Surgery Center PLLC's practice location on file with NPPES is 23 Sawtelle Ave, Rexburg, ID 83440.
- What is Henrys Fork Surgery Center PLLC's phone number?
- The practice phone number listed in the NPPES registry for Henrys Fork Surgery Center PLLC is (208) 359-1888.
- Does Henrys Fork Surgery Center PLLC accept Medicare?
- Henrys Fork Surgery Center PLLC is approved to bill Medicare according to CMS PECOS enrollment data (2026.04.01). Confirm current participation with the provider before scheduling.
- Who is the authorized official for Henrys Fork Surgery Center PLLC?
- The authorized official listed on Henrys Fork Surgery Center PLLC's NPPES record is Jeremy Johnson, Manager. The authorized official registers and maintains the organization's NPI and is not necessarily its owner.
- Is Henrys Fork Surgery Center PLLC's NPI active?
- Yes — Henrys Fork Surgery Center PLLC's NPI (1235768490) is active in the NPPES registry as of the last update on 2025-06-19.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.