Center for Southside Surgery, LLC

Primary specialty

Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X

Legal business name

CENTER FOR SOUTHSIDE SURGERY, LLC

Practice address

533 E County Line Rd
Suite 201
Greenwood, IN 46143-1073

Phone

(317) 706-7246

Fax

(317) 706-3419

NPI assigned

Aug 7, 2015

Organization subpart

No

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

Authorized official

Name

Christina Mandabach

Title

Director of Business Ops

Phone

(317) 706-7246

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in IN

Enrollment records 1

Listed as

Center for Southside SurgeryCCN 15C0001199

Medicare certification status

ActiveFrom the Provider of Services file

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

CLIA laboratory certificates

Locations

Practitioners 6

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

• Jocelyn L. Bush, M.D.

  • Interventional Pain Medicine Physician
  • Indianapolis, IN
  • NPI 1447356704
  Medicare reassignment NPD
• David Michael Gordon, MD

  • Interventional Pain Medicine Physician
  • Indianapolis, IN
  • NPI 1760724603
  Medicare reassignment NPD
• Scott Sang Won Kim, M.D.

  • Interventional Pain Medicine Physician
  • Greenwood, IN
  • NPI 1164650461
  Medicare reassignment NPD
• Barbara Ann Kovacs, NURSE PRACTITIONER

  • Family Nurse Practitioner
  • Indianapolis, IN
  • NPI 1073695268
  Medicare reassignment NPD
• Edward J Kowlowitz, M.D.

  • Interventional Pain Medicine Physician
  • Indianapolis, IN
  • NPI 1972590529
  Medicare reassignment NPD
• John Joseph Fitzgerald, M.D.

  • Interventional Pain Medicine Physician
  • Indianapolis, IN
  • NPI 1700873148
  NPD

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

{
    "created_epoch": "1438905600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1763424000000",
    "number": "1003292483",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "29945 NETWORK PL",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606731299",
            "telephone_number": "317-706-7246",
            "fax_number": "317-706-3419"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "533 E COUNTY LINE RD",
            "address_2": "SUITE 201",
            "city": "GREENWOOD",
            "state": "IN",
            "postal_code": "461431073",
            "telephone_number": "317-706-7246",
            "fax_number": "317-706-3419"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CENTER FOR SOUTHSIDE SURGERY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-08-07",
        "last_updated": "2025-11-18",
        "certification_date": "2025-11-18",
        "status": "A",
        "authorized_official_last_name": "MANDABACH",
        "authorized_official_first_name": "CHRISTINA",
        "authorized_official_title_or_position": "DIRECTOR OF BUSINESS OPS",
        "authorized_official_telephone_number": "317-706-7246"
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": "IN",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "201358590A",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Sarah E Casper, NP
• Rebecca Castro
• Jennifer Cater
• Ashlee Cave, D.D.S.
• Cynthia A Caywood, PT
• Center for Vascular Medicine in LLC
• Center for Vein Restoration in, LLC
• Center for Women'S Health Imaging
• Center Grove Community School Corporation
• Center Grove Dental, LLC

• Ambulatory Surgical Clinic/Center in Greenwood, IN
• Providers in Greenwood, IN by specialty
• Ambulatory Surgical Clinic/Center in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 18, 2025; 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.