Roanoke Ambulatory Surgery Center, LLC

Primary specialty

Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X

License

OH636 Issued in VA

Legal business name

ROANOKE AMBULATORY SURGERY CENTER, LLC

Practice address

1102 S Jefferson St
Roanoke, VA 24016-4704

Phone

(540) 342-5800

NPI assigned

Jul 6, 2005

Organization subpart

No

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

Authorized official

Name

Thomas K Miller, M.D.

Title

Medical Director

Phone

(540) 342-0707

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• Roanoke Ambulatory Surgery Center Doing business as

Medicare fee-for-service enrollment

Enrolled in VA

Enrollment records 1

Listed as

Roanoke Ambulatory Surgery Center LLCCCN 49C0001030

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

Practitioners 1

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

• Vivian H. Mao, M.D.

  • Otolaryngology Physician
  • Roanoke, VA
  • NPI 1548264377
  NPD (past)

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

{
    "created_epoch": "1120608000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1744070400000",
    "number": "1013914985",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1102 S JEFFERSON ST",
            "city": "ROANOKE",
            "state": "VA",
            "postal_code": "240164704",
            "telephone_number": "540-342-5800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1102 S JEFFERSON ST",
            "city": "ROANOKE",
            "state": "VA",
            "postal_code": "240164704",
            "telephone_number": "540-342-5800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ROANOKE AMBULATORY SURGERY CENTER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-07-06",
        "last_updated": "2025-04-08",
        "certification_date": "2025-04-08",
        "status": "A",
        "authorized_official_last_name": "MILLER",
        "authorized_official_first_name": "THOMAS",
        "authorized_official_middle_name": "K",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "540-342-0707",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": "VA",
            "license": "OH636",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DEPARTMENT OF LABOR ID NU",
            "identifier": "125459800",
            "state": "VA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "010053919",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Roanoke Ambulatory Surgery Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Brett Reagan Roach, L.P.C., L.M.F.T.
• Gary A. Roach, D.D.S.
• Karah Kittinger Roach
• Roanoke Adult Medicine LLC
• Roanoke Airport Transportation Service Inc
• Roanoke Birth and Perinatal Center
• Roanoke Breast Care, Inc
• Roanoke Chiropractic Services, PLLC
• Roanoke City Health Department
• Roanoke City Public Schools

• Ambulatory Surgical Clinic/Center in Roanoke, VA
• Providers in Roanoke, VA by specialty
• Ambulatory Surgical Clinic/Center in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 8, 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.