Granite Mountain Surgery PLLC
NPI 1477359909ActiveOrganization· Surgery· Boise, ID
Surgery in Boise, Idaho, registered in NPPES in February 2025. The authorized official on file is Amber L. Elliott, MD, Owner. Enrolled in Medicare as part b supplier - clinic/group practice.
Overview
| NPI | 1477359909 |
|---|---|
| Status | Active |
| Entity type | Organization |
| NPI issued | Feb 24, 2025 |
| Last updated in NPPES | Feb 24, 2025 |
| Certified by provider | Feb 24, 2025 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Surgery Primary | 208600000X | — | — |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Oct 9, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 10, 2026 | No match | — |
| New York OMIG · Nov 10, 2026 | No match | — |
| Ohio Medicaid · Nov 10, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 10, 2026 | No match | — |
| Washington HCA · Nov 10, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled Part B Supplier - Clinic/Group Practice (ID) |
|---|
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