Michigan Advanced Surgical Center, PLLC

Primary specialty

Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X

Legal business name

MICHIGAN ADVANCED SURGICAL CENTER, PLLC

Practice address

27101 Schoenherr Rd Ste 300
Warren, MI 48088-4700

Phone

(586) 434-3210

Fax

(586) 434-3214

NPI assigned

Apr 30, 2020

Last updated

Apr 22, 2021By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mr. Jeffrey A Poulsen

Title

Cfo

Phone

(586) 434-3211

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MI

Enrollment records 1

Listed as

Michigan Advanced Surgical CenterCCN 23C0001149

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, and the practitioner matching its NPPES authorized official.

• Martin Quiroga, D.O.

  • Surgery Physician
  • Warren, MI
  • NPI 1184814303
  Medicare reassignment NPD
• Alexander Cole-Selvaggio, ANP-BC

  • Nurse Practitioner
  • Warren, MI
  • NPI 1053737676
  NPD (past)
• Brian Fiani, D.O., F.A.C.O.S.

  • Neurological Surgery Physician
  • Shelby Township, MI
  • NPI 1366835662
  NPD (past)
• David Kocenda, FNP-C

  • Family Nurse Practitioner
  • Lapeer, MI
  • NPI 1124487665
  NPD (past)
• Ramiro Antonio Perez de la Torre, MD

  • Neurological Surgery Physician
  • Garden City, MI
  • NPI 1689909343
  NPD (past)
• Marette R. Zaki, MD

  • Anesthesiology Physician
  • Detroit, MI
  • NPI 1306048459
  NPD (past)

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

{
    "created_epoch": "1588204800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1619049600000",
    "number": "1033730098",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "27101 SCHOENHERR RD STE 300",
            "city": "WARREN",
            "state": "MI",
            "postal_code": "480884700",
            "telephone_number": "586-434-3210",
            "fax_number": "586-434-3214"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "27101 SCHOENHERR RD STE 300",
            "city": "WARREN",
            "state": "MI",
            "postal_code": "480884700",
            "telephone_number": "586-434-3210",
            "fax_number": "586-434-3214"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MICHIGAN ADVANCED SURGICAL CENTER, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-04-30",
        "last_updated": "2021-04-22",
        "certification_date": "2021-04-22",
        "status": "A",
        "authorized_official_last_name": "POULSEN",
        "authorized_official_first_name": "JEFFREY",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "586-434-3211",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Gullan Saeed Michel
• Jean-Luc Michel, MD
• Samantha Marie Michelini
• Michigan Adult & Child Medicine
• Michigan Advanced Orthopedics
• Michigan Center for Fertility and Womens Health, PLC
• Michigan Center for Hematology and Oncology
• Michigan Center Ivf, PLLC
• Michigan Compassionate Care L.L.C.
• Michigan Diagnostic Alcohol and Drug Services LLC

• Ambulatory Surgical Clinic/Center in Warren, MI
• Providers in Warren, MI by specialty
• Ambulatory Surgical Clinic/Center in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 22, 2021; 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.