SKYLINE SURGERY CENTER, LLC
NPI 1851552483
Clinic/Center - Ambulatory Surgical in Pocatello, ID

NPI Status: Active since June 17, 2008

Contact Information

285 VISTA DR
STE C
POCATELLO, ID
ZIP 83201
Phone: (208) 478-1704
Fax: (208) 233-6970

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  • Organization
  • Clinic/Center
  • Ambulatory Surgical
  • Accepts Insurance
  • Medicare Supplier
  • Accepts Medicare Approved Payment
  • CLIA Number: 13D2053554
  • CLIA Cert. Type: Ambulatory Surgery Center
  • CLIA Exp. Date: 02-03-2027

About SKYLINE SURGERY CENTER, LLC

This page provides the complete NPI Profile along with additional information for Skyline Surgery Center, Llc, a provider established in Pocatello, Idaho operating as a Clinic/center, focusing in ambulatory surgical . The healthcare provider is registered in the NPI registry with number 1851552483 assigned on June 2008. The practitioner's primary taxonomy code is 261QA1903X. The provider is registered as an organization and their NPI record was last updated 7 years ago. The provider's former legal business name is Skyline Surgery Center Inc. The authorized official of this NPI record is Kathryn Buckalew (Administrator)

NPI
1851552483
Provider Legal Name
SKYLINE SURGERY CENTER, LLC
Other Organization Name
SKYLINE SURGERY CENTER INC
Other Name Type
Former Legal Business Name (4)
Entity Type
Organization
Location Address
285 VISTA DR STE C POCATELLO, ID 83201
Location Phone
(208) 478-1704
Location Fax
(208) 233-6970
Mailing Address
285 VISTA DRIVE SUITE C POCATELLO, ID 83201
Mailing Phone
(208) 478-1704
Mailing Fax
(208) 233-6970
Is Sole Proprietor?
No
Is Organization Subpart?
No
Enumeration Date
06-17-2008
Last Update Date
05-31-2018
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Skyline Surgery Center, Llc is a medicare supplier with PTAN 26716516 who accepts Medicare assignment for all durable medical equipment and supplies. The provider accepts the Medicare allowable as payment in full.The supplier carries the following product categories: Breast Prostheses and/or Accessories or Neurostimulators and/or Supplies or Prosthetic Lenses: Prosthetics Cataract Lenses.

Location Map

Specialty - Primary Taxonomy

The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Classification

Clinic/Center Ambulatory Surgical

Taxonomy Code
261QA1903X
Type
Ambulatory Health Care Facilities

Insurance Plans Accepted

According to publicly available information the provider might be accepting the following health plans from these health insurance companies:

  • Moda Select Bronze 8700 ($0 Virtual Urgent Care through CirrusMD) - EPO
  • Moda Select Bronze HDHP 7500 - EPO
  • Moda Select Gold 1000 ($0 Virtual Urgent Care through CirrusMD) - EPO
  • Moda Select Gold 1800 ($0 Virtual Urgent Care through CirrusMD) - EPO
  • Moda Select Silver 3500 ($0 Virtual Urgent Care through CirrusMD) - EPO
  • Moda Select Silver 4800 ($0 Virtual Urgent Care through CirrusMD) - EPO
  • Moda Select Silver 6400 ($0 Virtual Urgent Care through CirrusMD) - EPO
  • Moda Select Texas Standard Bronze - EPO
  • Moda Select Texas Standard Gold - EPO
  • Moda Select Texas Standard Silver - EPO
  • Connect Bronze Expanded Standard - PPO
  • Connect Bronze HDHP - PPO
  • Connect Catastrophic - PPO
  • Connect Gold - PPO
  • Connect Gold Standard - PPO
  • Connect Silver - PPO
  • Connect Silver Standard - PPO
  • High Plains Bronze HDHP - PPO
  • High Plains Bronze Standard Expanded - PPO
  • High Plains Gold - PPO
  • High Plains Gold HDHP - PPO
  • High Plains Gold Standard - PPO
  • High Plains Silver - PPO
  • High Plains Silver Standard - PPO
  • Plus Bronze Expanded - PPO
  • Plus Bronze Standard Expanded - PPO
  • Plus Gold - PPO
  • Plus Gold Standard - PPO
  • Plus Silver Standard - PPO
  • ACCESS BRONZE - PPO
  • Navigator Bronze 7000 Exchange - PPO
  • Navigator Bronze 9200 - PPO
  • Navigator Bronze HSA 8050 - PPO
  • Navigator Gold 1500 - PPO
  • Navigator Gold 1500 Exchange - PPO
  • Navigator Gold 500 Exchange - PPO
  • Navigator Silver 3500 Exchange - PPO
  • Navigator Silver 4000 Exchange - PPO
  • Navigator Silver 5000 - PPO
  • Navigator Silver HSA 3500 - PPO
  • Navigator Standard Expanded Bronze - PPO
  • Navigator Standard Gold - PPO
  • Navigator Standard Silver - PPO
  • PacificSource Oregon Standard Bronze Plan NAV - PPO
  • PacificSource Oregon Standard Gold Plan NAV - PPO
  • PacificSource Oregon Standard Silver Plan NAV - PPO
  • Healthy Premier Bronze HSA - EPO
  • Healthy Premier Expanded Bronze Standard - EPO
  • Healthy Premier Gold Copay - EPO
  • Healthy Premier Gold Standard - EPO
  • Healthy Premier Silver Copay - EPO
  • Healthy Premier Silver Standard - EPO

*Please verify directly with this provider to make sure your insurance plan is currently accepted.

Authorized Official

The authorized official is the designated individual with the legal authority to make changes to the provider’s official NPI record. For organizations, the authorized official must be a general partner, chairman of the board, CEO, CFO or a direct owner holding at least a 5 percent stake in the medical organization.

Authorized Official Name

KATHRYN BUCKALEW

Authorized Official Title
ADMINISTRATOR
Authorized Official Phone
(208) 785-3877

Areas of Expertise

The following services and procedures, recently provided to Medicare patients, illustrate the range of care this provider offers. This list reflects the variety of services available to all patients visiting the practice and is based on 2022 Medicare dataset. In general, the more frequently a provider treats specific conditions or performs particular procedures, the more experienced they become in addressing similar patient needs. The provider has delivered many of the services listed below to Medicare patients. Please note that this list does not include services provided to patients who are not covered by Medicare.

Aspiration and/or injection of fluid from large joint

This procedure involves using a needle to remove (aspiration) or introduce (injection) fluid into a large joint like the knee or hip. It can help diagnose conditions, relieve discomfort, or deliver medication directly to the joint.

This service was performed 149 times for 62 patients

Biopsy of esophagus, stomach, and/or upper small bowel using a flexible endoscope

This procedure involves using a thin, flexible tube with a light and camera, known as an endoscope, to examine the esophagus, stomach, and upper part of the small intestine. Small tissue samples are taken for further examination to help diagnose various conditions.

This service was performed 61 times for 60 patients

Biopsy of large bowel using a flexible endoscope

A biopsy of the large bowel using a flexible endoscope is a procedure where a thin, flexible tube with a camera is inserted through the rectum to examine the bowel. If abnormal tissue is found, a small sample is taken for further examination. This helps in diagnosing conditions like inflammation, polyps, or cancer.

This service was performed 38 times for 38 patients

Colorectal cancer screening; colonoscopy on individual not meeting criteria for high risk

Colorectal cancer screening, such as a colonoscopy, is a preventive measure to detect early signs of cancer in the large intestine. For individuals not at high risk, it's typically recommended at age 50. A small, flexible tube with a camera is used to examine your colon. It's a safe, effective way to catch issues early.

This service was performed 13 times for 13 patients

Destruction of lower or sacral spinal facet joint nerves using imaging guidance, single facet joint

This procedure involves using imaging guidance to accurately target and destroy nerves in the lower or sacral spinal facet joint. It's done to relieve chronic back pain. The process is safe and usually effective.

This service was performed 156 times for 70 patients

Destruction of upper or middle spinal facet joint nerves using imaging guidance, single facet joint

This procedure involves the use of imaging technology to guide a needle to the nerves of a single facet joint in the upper or middle spine. The nerves are then treated to alleviate pain and improve mobility.

This service was performed 19 times for 12 patients

Diagnostic exam of large bowel using a flexible endoscope

This procedure, known as a colonoscopy, involves using a flexible tube with a light and camera to examine the large intestine. It helps detect any abnormalities such as polyps or inflammation. It's a standard procedure to ensure gut health.

This service was performed 20 times for 20 patients

Incision of tendon covering of finger

This procedure involves making a small cut into the protective sheath around a finger tendon. It's typically done to relieve pressure or inflammation, improve finger movement, or treat conditions like trigger finger. It's a safe, often outpatient procedure.

This service was performed 34 times for 25 patients

Injection of lower or sacral spine facet joint using imaging guidance, single level

This procedure involves injecting medication into the facet joint in your lower back or sacral spine. It's done under imaging guidance to ensure accuracy. The aim is to alleviate pain and inflammation. It's a safe, often effective method for managing spinal discomfort.

This service was performed 125 times for 38 patients

Injection of substance into lower spine canal using imaging guidance

This procedure involves injecting a substance into your lower spine canal, guided by real-time images. It's done to diagnose or treat various conditions. You may feel slight discomfort, but it's generally safe and can provide valuable information for your treatment plan.

This service was performed 72 times for 56 patients

Injection of substance into middle or upper spine canal using imaging guidance

This procedure involves injecting a substance into your middle or upper spine canal. It's performed under imaging guidance to ensure accuracy. The substance can help diagnose or treat various conditions, providing relief from symptoms.

This service was performed 37 times for 25 patients

Injection procedure for sacroiliac joint; provision of anesthetic, steroid and/or other therapeutic agent, with or without arthrography

This procedure involves injecting medicine into the sacroiliac joint, located in the lower back. The aim is to reduce inflammation and pain. Anesthetic is used for immediate pain relief, while a steroid helps decrease inflammation over time. Arthrography, a type of imaging, may be used for precision.

This service was performed 148 times for 71 patients

Insertion of guide wire with dilation of esophagus using a flexible endoscope

This is a procedure where a thin tube, called an endoscope, is gently passed through your mouth into your esophagus. A guide wire is then inserted to help widen any narrow areas. This helps improve swallowing and reduce discomfort.

This service was performed 28 times for 26 patients

Phenylephrine 10.16 mg/ml and ketorolac 2.88 mg/ml ophthalmic irrigation solution, 1 ml

This solution is used during eye surgery to maintain pupil dilation and reduce inflammation. Phenylephrine widens the pupil, while Ketorolac helps to prevent pain and swelling. It's applied directly to the eye by your healthcare provider during the procedure.

This service was performed 70 times for 29 patients

Release and/or relocation of elbow nerve

This procedure involves adjusting the position of a nerve in your elbow to alleviate discomfort or improve function. The nerve is carefully moved from its original location and placed in a less strained position. This can help reduce pain and improve arm movement.

This service was performed 15 times for 14 patients

Release and/or relocation of hand nerve

This procedure involves adjusting or moving a nerve in your hand to alleviate discomfort or improve function. The nerve may be compressed, causing pain or numbness. By releasing or relocating the nerve, these symptoms can be reduced, enhancing hand usage.

This service was performed 48 times for 39 patients

Release and/or relocation of wrist nerve

This procedure involves adjusting or freeing a nerve in your wrist to alleviate discomfort or improve function. It's often performed when a nerve is compressed, causing conditions like carpal tunnel syndrome. The goal is to restore your hand's normal function and relieve pain.

This service was performed 16 times for 13 patients

Removal of cataract with insertion of prosthetic lens

This is a procedure where a cloudy lens in your eye, known as a cataract, is removed. After removal, a clear artificial lens is inserted. This helps to restore your vision, enabling you to see clearly again.

This service was performed 243 times for 151 patients

Removal of excessive skin and fat of upper eyelid

This procedure, also known as upper eyelid surgery, is performed to remove excess skin and fat from the upper eyelid. It can help improve vision if heavy eyelids hinder it, and can also enhance the appearance of the eyes. It's a common, safe procedure.

This service was performed 60 times for 30 patients

Removal of polyps or growths of large bowel using an endoscope with mechanical snare

This procedure involves using a thin, flexible tube called an endoscope to examine the large bowel. If any abnormal growths or polyps are found, a tool called a mechanical snare is used to remove them. This is a common method to prevent potential health issues.

This service was performed 18 times for 18 patients

Removal of recurring cataract in lens capsule using a laser

This procedure, known as YAG laser capsulotomy, treats cloudiness in the lens capsule following cataract surgery. A laser is used to create a small hole in the cloudy capsule, allowing light to pass through and restore clear vision. It's a quick, painless procedure.

This service was performed 90 times for 79 patients

Repair of tendon of upper eyelid

Repair of the tendon of the upper eyelid is a surgical procedure aimed at fixing a droopy eyelid. This condition can affect your vision and appearance. The procedure involves tightening the tendon to lift the eyelid to its normal position, improving both function and aesthetics.

This service was performed 19 times for 11 patients

Medical Equipment Supplier

The provider carries the following medical supplies product categories:

PTAN
26716516
Accepts Medicare Assignment
YES
Provider Type List
AMBULATORY SURGICAL CENTER.
Competitive Bidding
NO

Supplies List

  • Breast Prostheses and/or Accessories - Prosthetic bra, Surgical bra
  • Neurostimulators and/or Supplies - Rechargable neurostimulators, Non-rechargable neurostimulators
  • Prosthetic Lenses: Prosthetics Cataract Lenses - Cataract Eyeglasses

CLIA Information

The Clinical Laboratory Improvement Amendments (CLIA) of 1988 applies to facilities or sites that test human specimens for health assessment or to diagnose, prevent, or treat disease. The CLIA Program sets standards for clinical laboratory testing and issues certificates. The NPI / CLIA crosswalk information for this NPI number is:

CLIA Number
13D2053554
Facility Type
Ambulatory Surgery Center
Certificate Effective Date
February 04, 2025
Certificate Expiration Date
February 03, 2027
Laboratory Director
DEB MEYER
Certificate Type
Certificate of Waiver
Certificate Type Description
This CLIA certificate is issued to Skyline Surgery Center, Llc to perform only waived tests. CLIA defines waived tests as simple tests with a low risk for an incorrect result. Waived tests include certain tests listed in CLIA regulations, tests cleared by the FDA for home use and tests approved by the FDA for waived status and that meet CLIA waiver criteria.

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NPI Validation Check Digit Calculation


The following table explains the step by step NPI number validation process using the ISO standard Luhn algorithm.

Start with the original NPI number, the last digit is the check digit and is not used in the calculation.
1851552483
Step 1: Double the value of the alternate digits, beginning with the rightmost digit.
281011054416
Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24.
2 + 8 + 1 + 0 + 1 + 1 + 0 + 5 + 4 + 4 + 1 + 6 + 24 = 57
Step 3: Subtract the total obtained in step 2 from the next higher number ending in zero, the result is the check digit.
60 - 57 = 33

The NPI number 1851552483 is valid because the calculated check digit 3 using the Luhn validation algorithm matches the last digit of the original NPI number.

Other Providers at the Same Location


The following 13 providers are registered at the same or nearby location.

NPI Name / Type Taxonomy Address
1043445513RYAN D. HOPE, M.D., LLC
Organization
Pain Medicine (Interventional Pain Medicine)285 VISTA DR
POCATELLO, ID 83201
(208) 233-8344
1972808806PSYCHIATRY-ECT, PLLC
Organization
Psychiatry & Neurology (Psychiatry)285 VISTA DR SUITE D
POCATELLO, ID 83201
(208) 233-8344
1053605907 LAURA M SPRAGUE DPT
Individual
Physical Therapist285 VISTA DR SUITE A
POCATELLO, ID 83201
(208) 478-1488
1164774923SM MALOFF MD PC
Organization
Plastic Surgery (Surgery of the Hand)285 VISTA DR
POCATELLO, ID 83201
(208) 239-0380
1356728810ANESTHESIA ZZZ LLC
Organization
Nurse Anesthetist, Certified Registered285 VISTA DR
POCATELLO, ID 83201
(208) 478-1704
1780062588KEZELE ANESTHETICS, P.C.
Organization
Nurse Anesthetist, Certified Registered285 VISTA DR
POCATELLO, ID 83201
(208) 478-1704
1588160881DANIEL ANESTHESIA PC
Organization
Nurse Anesthetist, Certified Registered285 VISTA DR
POCATELLO, ID 83201
(208) 478-1704
1003380783EDWARDS ENTERPRISES LLC
Organization
Nurse Anesthetist, Certified Registered285 VISTA DR
POCATELLO, ID 83201
(208) 478-1704
1245779412BMH, INC.
Organization
Pain Medicine (Interventional Pain Medicine)285 VISTA DR STE. E
POCATELLO, ID 83201
(208) 239-8023
1073857991VALLEY VIEW ANESTHESIA PA
Organization
Anesthesiology285 VISTA DR
POCATELLO, ID 83201
(208) 478-1704
1760712327MR. BEAU S. DANIEL CRNA
Individual
Nurse Anesthetist, Certified Registered285 VISTA DR
POCATELLO, ID 83201
(208) 478-1704
1144652694MR. TIMOTHY MORGAN NAYLOR CRNA
Individual
Nurse Anesthetist, Certified Registered285 VISTA DR
POCATELLO, ID 83201
(208) 478-1704
1336451400 RICHARD T SORENSEN DPT
Individual
Physical Therapist285 VISTA DR SUITE A
POCATELLO, ID 83201
(208) 478-1488

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1851552483, enumerated in the NPI registry as an "organization" on June 17, 2008

The provider is located at 285 Vista Dr Ste C Pocatello, Id 83201 and the phone number is (208) 478-1704

This medical organization specializes in Clinic/Center with taxonomy code 261QA1903X with a focus in Ambulatory Surgical

The provider might be accepting Accepts: Moda Health Plan, Inc., Mountain Health CO-OP,. Please consult your insurance carrier or call the provider to make sure your health plan is currently accepted.

The most common procedures or services performed by this practitioner are: Aspiration and/or injection of fluid from large joint, Biopsy of esophagus, stomach, and/or upper small bowel using a flexible endoscope, Biopsy of large bowel using a flexible endoscope, Colorectal cancer screening; colonoscopy on individual not meeting criteria for high risk, Destruction of lower or sacral spinal facet joint nerves using imaging guidance, single facet joint, Destruction of upper or middle spinal facet joint nerves using imaging guidance, single facet joint, Diagnostic exam of large bowel using a flexible endoscope, Incision of tendon covering of finger, Injection of lower or sacral spine facet joint using imaging guidance, single level, Injection of substance into lower spine canal using imaging guidance, Injection of substance into middle or upper spine canal using imaging guidance, Injection procedure for sacroiliac joint; provision of anesthetic, steroid and/or other therapeutic agent, with or without arthrography, Insertion of guide wire with dilation of esophagus using a flexible endoscope, Phenylephrine 10.16 mg/ml and ketorolac 2.88 mg/ml ophthalmic irrigation solution, 1 ml, Release and/or relocation of elbow nerve, Release and/or relocation of hand nerve, Release and/or relocation of wrist nerve, Removal of cataract with insertion of prosthetic lens, Removal of excessive skin and fat of upper eyelid, Removal of polyps or growths of large bowel using an endoscope with mechanical snare, Removal of recurring cataract in lens capsule using a laser and Repair of tendon of upper eyelid.

The provider's CLIA number is 13D2053554 for a "ambulatory surgery center" facility with a CLIA Certificate of Waiver. This CLIA certificate is issued to perform only waived tests. CLIA defines waived tests as simple tests with a low risk for an incorrect result. Waived tests include certain tests listed in CLIA regulations, tests cleared by the FDA for home use and tests approved by the FDA for waived status and that meet CLIA waiver criteria..

This NPI record was last updated on June 17, 2008. To officially update your NPI information contact the National Plan and Provider Enumeration System (NPPES) at 1-800-465-3203 (NPI Toll-Free) or by email at [email protected].
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