NPI age
10 years
Enumerated 2015-12-16
● Active Type 2 · Organization
Madison Avenue Surgery Center Llc
Madison Avenue Surgery Center Llc is 1 of 99 clinic/center organizations in Idaho.
Primary specialty
Clinic/Center
Practice locations
1
0 secondary on file
Status
Active
No deactivations on record
Authorized official
Freeman
President
Last NPPES update
2015-12-16
Source: monthly bulk 2026-05
How this organization compares
Across 99 active clinic/center providers in Idaho.
NPI age
10 years
↓ 8 yr below median
Practice locations
1
0 secondary on file
Subspecialties
0
NPI lifetime · 2015 → 2026
2015-12Enumerated in NPPES
2015
2026
Where they practice
Primary practice location
3760 Washington Pkwy
Idaho Falls, ID 834047593
Mailing address
3760 Washington Pkwy
Idaho Falls, ID 834047593
Authorized official
Mark Edward Freeman, MD
President
📞 2088815351
Individual providers at this organization
5 individual providers on file at this primary practice address.
- Michael Hartley, LCSW Social Worker NPI 1700995909
- Kierstin Nebeker, DNP Nurse Practitioner NPI 1760720064
- Angelina Norton, ACADC, MSW Counselor NPI 1891928602
- Richard Troyer, LCPC Counselor NPI 1033158613
- Kristopher Walton, LCSW Social Worker NPI 1851332464
Specialties
-
Clinic/Center PrimaryDefinition to come...
Practice context
Multi-provider organization. 5 individual providers on file at this primary address.
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- Confirm the NPI on NPPES.The CMS registry is the system of record. Open NPPES →
- Verify the organization is in good standing.Cross-check with the state's business registration and any applicable licensing boards.
- Confirm payer enrollment if billing.NPI presence does not guarantee active enrollment with Medicare, Medicaid, or commercial payers.