Desert Vista Surgical Center LLC

Primary specialty

Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X

Legal business name

DESERT VISTA SURGICAL CENTER LLC

Practice address

10117 N 92ND St Ste 103
Scottsdale, AZ 85258-4555

Phone

(480) 576-8700

NPI assigned

Aug 14, 2017

Organization subpart

No

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

Authorized official

Name

Aric Burke

Title

Director/Officer

Phone

(480) 689-8403

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in AZ

Enrollment records 1

Listed as

Desert Vista Surgical CenterCCN 03C0001439

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

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

{
    "created_epoch": "1502668800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1717459200000",
    "number": "1003332883",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10117 N 92ND ST STE 103",
            "city": "SCOTTSDALE",
            "state": "AZ",
            "postal_code": "852584555"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10117 N 92ND ST STE 103",
            "city": "SCOTTSDALE",
            "state": "AZ",
            "postal_code": "852584555",
            "telephone_number": "480-576-8700"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "9819 N 95th St Ste 110",
            "address_purpose": "LOCATION",
            "city": "Scottsdale",
            "state": "AZ",
            "postal_code": "852584588",
            "country_code": "US",
            "telephone_number": "480-874-2229",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "DESERT VISTA SURGICAL CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-08-14",
        "last_updated": "2024-06-04",
        "certification_date": "2024-06-04",
        "status": "A",
        "authorized_official_last_name": "BURKE",
        "authorized_official_first_name": "ARIC",
        "authorized_official_title_or_position": "DIRECTOR/OFFICER",
        "authorized_official_telephone_number": "480-689-8403"
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Desert Stream Urology
• Desert Surgery Center
• Desert Tranquility Integrated Wellness Services LLC
• Desert Vascular Technologies
• Desert View Christian Science Care
• Emily Desjardins
• Stephen S Desjardins, OTR/L, CHT
• Vidal Manuel Despradel, MD
• Destinys Loving Home LLC
• Alison Faye Dethlefs, NP

• Ambulatory Surgical Clinic/Center in Scottsdale, AZ
• Providers in Scottsdale, AZ by specialty
• Ambulatory Surgical Clinic/Center in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 4, 2024; 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.