NPIMap

Organization Active NPI

Metdalspi, LLC

Doing business as Methodist Hospital for Surgery

  • General Acute Care Hospital
  • Addison, TX
National Provider Identifier
1023338142
Registry record updated Aug 16, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Acute Care HospitalTaxonomy code 282N00000X
Legal business name
METDALSPI, LLC
Doing business as
Methodist Hospital for Surgery
Practice address
17101 Dallas Parkway
Addison, TX 75001-7103
Phone
(469) 248-3900
Fax
(469) 248-3901
NPI assigned
Jun 11, 2010
Last updated
Aug 16, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 16, 2023

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

Authorized official

Name
Jennifer Boyd Baldock
Title
Officer and Authorized Official
Phone
(615) 234-5954

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Acute Care Hospital 282N00000X Primary

Addresses

Primary practice location

17101 Dallas Parkway
Addison, TX 75001-7103

Mailing address

17101 Dallas Parkway
Addison, TX 75001-7103
Phone (469) 248-3900

Other names 1

  • Methodist Hospital for Surgery Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20100805000457 TX Part A Provider - Hospital 1658404025 Practice locations: Richardson, TX; Plano, TX; Denton, TX; Dallas, TX; Addison, TX

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1023338142. Details of each certification follow.

Hospital certification: CCN 670073

Legal name
METDALSPI LLC
Doing business as
METHODIST HOSPITAL FOR SURGERY
Certification status
Active
Provider type (POS)
Hospital – Short-term
Participating since
Dec 1, 2010
Last certification
Oct 13, 2022
Beds
32
Ownership / control type
Private (for profit)
Organization structure
LLCProprietary
Incorporated
Jul 22, 2008 in TX
Enrollment address
17101 Dallas Pkwy
Addison, TX 75001-7103
Other Hospital Practice Location
Hospital subgroups
General

Care Compare: Hospital

Medicare Care Compare
Listed as
Methodist Hospital for SurgeryCCN 670073 · All quality measures
Overall star rating
4 of 5
Type
Acute Care Hospitals
Ownership
Proprietary
Medicare certification status
ActiveFrom the Provider of Services file
Emergency services
Yes

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
45D2013404Methodist Hospital for Surgery17101 Dallas Parkway, Addison, TX 75001ComplianceFeb 19, 2027

National Provider Directory

National Provider Directory

Member of 3

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

Locations

17051 Dallas Pkwy
Ste 210
Addison, TX 75001
Phone (972) 685-7345

17051 Dallas Pkwy
Ste 430
Addison, TX 75001
Phone (469) 248-3962

17101 Dallas Pkwy
Ste 210
Addison, TX 75001
Phone (469) 248-3914

17101 Dallas Pkwy
Ste 250
Addison, TX 75001
Phone (972) 685-7330

3733 N Josey Ln
Ste 100
Carrollton, TX 75007
Phone (972) 395-7445

11970 N Central Expy
Ste 640
Dallas, TX 75243
Phone (214) 812-9490

3423 Trinity Mills Rd
Ste 520
Dallas, TX 75287
Phone (972) 662-1700

7616 LBJ
Ste 515
Dallas, TX 75251
Phone (214) 382-2997

4210 Mesa Dr
Denton, TX 76207
Phone (940) 320-6219

2301 Coit Rd
Plano, TX 75075
Phone (972) 599-9191

3012 Communications Pkwy
Ste 100
Plano, TX 75093
Phone (469) 467-6868

375 Municipal Dr
Ste 108
Richardson, TX 75080
Phone (214) 575-4040

Ownership & related parties

All disclosed owners & managing parties 10

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
SP Holdco I Inc Organization, Brentwood, TN Corporation 5% Or Greater Indirect Ownership Interest Jul 1, 2023 10%
Jennifer B Baldock Individual Corporate OfficerOfficer and Authorized Official Jul 1, 2023
SP Management Services Inc Organization, Brentwood, TN Corporation Operational/Managerial Control Jul 1, 2023
Edward Sopiarz Individual Corporate OfficerCfo Jan 1, 2019
W-2 Managing EmployeeCfo Jan 1, 2019
Surgery Partners Inc Organization, Brentwood, TN Corporation 5% Or Greater Indirect Ownership Interest Jul 1, 2023 10%
Methodist Hospitals of Dallas Organization, Dallas, TX Corporation 5% Or Greater Indirect Ownership Interest Jul 1, 2023 41%
Thomas E. Klawiter Individual Corporate OfficerCeo/President Aug 6, 2018
W-2 Managing EmployeeCeo/President Aug 6, 2018
Surgery Center Holdings Inc Organization, Brentwood, TN Corporation 5% Or Greater Indirect Ownership Interest Jul 1, 2023 10%
Surgery Center Holdings LLC Organization, Brentwood, TN LLC 5% Or Greater Indirect Ownership Interest Jul 1, 2023 10%
Metdalspi Holding Organization, Addison, TX LLC 5% Or Greater Direct Ownership Interest Oct 29, 2008 51%

Owners & managing parties with NPI records 8

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

Facilities with the same owner 33

Facilities that share an organizational owner with 5% or greater ownership or operational control.

View all 33

Practitioners & affiliated clinicians

Practitioners 43

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 43

Affiliated clinicians 277

Clinicians who list this facility as an affiliation in Medicare Care Compare.

View all 277

NPI Registry JSON

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

{
    "created_epoch": "1276214400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1692144000000",
    "number": "1023338142",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17101 DALLAS PARKWAY",
            "city": "ADDISON",
            "state": "TX",
            "postal_code": "750017103",
            "telephone_number": "469-248-3900",
            "fax_number": "469-248-3901"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17101 DALLAS PARKWAY",
            "city": "ADDISON",
            "state": "TX",
            "postal_code": "750017103",
            "telephone_number": "469-248-3900",
            "fax_number": "469-248-3901"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "METDALSPI, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-06-11",
        "last_updated": "2023-08-16",
        "certification_date": "2023-07-26",
        "status": "A",
        "authorized_official_last_name": "BALDOCK",
        "authorized_official_first_name": "JENNIFER",
        "authorized_official_middle_name": "BOYD",
        "authorized_official_title_or_position": "OFFICER AND AUTHORIZED OFFICIAL",
        "authorized_official_telephone_number": "615-234-5954"
    },
    "taxonomies": [
        {
            "code": "282N00000X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Methodist Hospital for Surgery",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Methodist Hospital for Surgery",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Addison, TX

Sources for this page

Verify at the official NPI Registry.