Organization Active NPI

New Albany Surgery Center, LLC

  • Ambulatory Surgical Clinic/Center
  • New Albany, OH
National Provider Identifier
1003103474
Registry record updated Jan 28, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X
Legal business name
NEW ALBANY SURGERY CENTER, LLC
Practice address
5040 Forest Dr
New Albany, OH 43054-8181
Phone
(614) 546-4300
Fax
(614) 546-4086
NPI assigned
Jul 6, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 28, 2019

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Mr. Mark E Gittins, D.O.
Title
Medical Director
Phone
(614) 327-1462

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ambulatory Surgical Clinic/Center 261QA1903X Primary

Addresses

Primary practice location

5040 Forest Dr
New Albany, OH 43054-8181

Mailing address

5040 Forest Dr Ste 100
New Albany, OH 43054-9187
Phone (614) 775-1616

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20111028000379 OH Part B Supplier - Ambulatory Surgical Center 7618140138 Practice locations: New Albany, OH

Care Compare: Ambulatory surgical center

Medicare Care Compare
Listed as
New Albany Surgery Center LLCCCN 36C0001267
Medicare certification status
ActiveFrom the Provider of Services file

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
36D2027444New Albany Surgery Center5040 Forest Drive Suite 100, New Albany, OH 43054Certificate of waiverJul 25, 2027

National Provider Directory

National Provider Directory

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

Networks

  • OH PPO

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1309910400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1548633600000",
    "number": "1003103474",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5040 FOREST DR STE 100",
            "city": "NEW ALBANY",
            "state": "OH",
            "postal_code": "430549187",
            "telephone_number": "614-775-1616",
            "fax_number": "614-775-1661"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5040 FOREST DR",
            "city": "NEW ALBANY",
            "state": "OH",
            "postal_code": "430548181",
            "telephone_number": "614-546-4300",
            "fax_number": "614-546-4086"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NEW ALBANY SURGERY CENTER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-07-06",
        "last_updated": "2019-01-28",
        "status": "A",
        "authorized_official_last_name": "GITTINS",
        "authorized_official_first_name": "MARK",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "614-327-1462",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "D.O."
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New Albany, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 28, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.