Unknown Individual – Orthopaedic Surgery Physician, NPI 1124017652
Orthopaedic Surgery Physician
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
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Provider Addresses for Unknown Individual
910, Northwest 16th Street, Fruitland, Payette County, Idaho, 83619, United States
# 205
FRUITLAND, ID 836192265
Phone: (541) 889-3111
Fax: (541) 889-3999
Type: Mailing
1050, Southwest 3rd Avenue, Ontario, Malheur County, Oregon, 97914, United States
SUITE 1200
ONTARIO, OR 979142193
Phone: (541) 889-3111
Fax: (541) 889-3999
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 4 Open Payments records for all available years, with a total value of $67.
Total Amount is formed as General ($67) + Research ($0) + Ownership ($0) = $67.
Last reported payment date: 2023-05-23 • Largest payer in this snapshot: Stryker Corporation ($46).
Total Amount
$67
General + Research + Ownership
Payments
4
Total payment records
General Amount
$67
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2023-05-23
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| Stryker Corporation | $46 |
| Vericel Corporation | $21 |
Medicare Enrollment & Revalidation
Source: CMS public data · Not endorsed by CMS ·
Educational use only—not medical, billing, or legal advice.
No Medicare enrollment or revalidation data available for this provider in our database.
Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS
Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
Educational use only—not medical, billing, or legal advice.
Top Medicare procedures (2023) · refreshed 2026-05-27
| HCPCS | Description | Services | Beneficiaries | Medicare allowed |
|---|---|---|---|---|
| 99214 | Established patient office or other outpatient visit, 30-39 minutes | 46 | 45 | $0 |
| 99213 | Established patient office or other outpatient visit, 20-29 minutes | 34 | 30 | $0 |
| 20985 | Computer-assisted surgery for muscle and bone procedure | 22 | 22 | $0 |
| 73560 | X-ray of knee, 1-2 views | 17 | 11 | $0 |
| 99204 | New patient office or other outpatient visit, 45-59 minutes | 16 | 16 | $0 |
Insurance plans in this area (ZIP 83619)
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Provider's Procedures
Group practice members
| Name | Specialty | State |
|---|---|---|
| Nurse Practitioner | ID | |
| O B S T E T R I C S/ G Y N E C O L O G Y | ID | |
| Orthopedic Surgery | ID | |
| Physician Assistant | ID | |
| General Surgery | OR | |
| Physician Assistant | ID | |
| General Surgery | ID | |
| O T O L A R Y N G O L O G Y | ID | |
| - | OR | |
| Physician Assistant | ID |
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