Bonneville Surgery Center LLC
NPI 1366256943 · Ambulatory Surgical Clinic/Center · Idaho Falls, ID
Enrolled with Medicare as Part B Supplier - Ambulatory Surgical Center · source: CMS PECOS Public Provider Enrollment (2026.04.01)
Bonneville Surgery Center LLC is a Ambulatory Surgical Clinic/Center organization in Idaho Falls, ID (NPI 1366256943).
Provider details
- NPI number
- 1366256943
- Entity type
- Organization
- Primary specialty
- Ambulatory Surgical Clinic/CenterAmbulatory Health Care Facilities
- Organization subpart
- No
- Authorized official
- Derek Van Orden, Secretary(208) 715-8220
Specialties & taxonomies
Ambulatory Health Care Facilities
Profile Score
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
1 yr in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
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.
Practice location
Mailing address
Registry dates
- Enumerated
- 2025-02-04
- Last updated
- 2025-02-04
- Certified
- 2025-02-04
Frequently asked questions
- What is Bonneville Surgery Center LLC's NPI number?
- Bonneville Surgery Center LLC's National Provider Identifier (NPI) is 1366256943, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What type of organization is Bonneville Surgery Center LLC?
- Bonneville Surgery Center LLC is classified in the NPPES registry as Ambulatory Surgical Clinic/Center (Ambulatory Health Care Facilities).
- Where is Bonneville Surgery Center LLC located?
- Bonneville Surgery Center LLC's practice location on file with NPPES is 2001 S Woodruff Ave Ste 6, Idaho Falls, ID 83404-6371.
- What is Bonneville Surgery Center LLC's phone number?
- The practice phone number listed in the NPPES registry for Bonneville Surgery Center LLC is (208) 715-8220.
- Does Bonneville Surgery Center LLC accept Medicare?
- Bonneville Surgery Center LLC 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 Bonneville Surgery Center LLC?
- The authorized official listed on Bonneville Surgery Center LLC's NPPES record is Derek Van Orden, Secretary. The authorized official registers and maintains the organization's NPI and is not necessarily its owner.
- Is Bonneville Surgery Center LLC's NPI active?
- Yes — Bonneville Surgery Center LLC's NPI (1366256943) is active in the NPPES registry as of the last update on 2025-02-04.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.