Standard Surgical LLC

Primary specialty

Surgical Physician AssistantTaxonomy code 363AS0400X

Legal business name

STANDARD SURGICAL LLC

Practice address

5115 N Dysart Rd Ste 202-197
Litchfield Park, AZ 85340-3032

Phone

(801) 647-5158

NPI assigned

Mar 5, 2017

Organization subpart

No

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

Authorized official

Name

Elliot Steadman

Title

Sole Member

Phone

(801) 647-5158

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1488672000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1524182400000",
    "number": "1043750490",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 29650",
            "address_2": "DEPT 880187",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850389650",
            "telephone_number": "801-647-5158"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5115 N DYSART RD STE 202-197",
            "city": "LITCHFIELD PARK",
            "state": "AZ",
            "postal_code": "853403032",
            "telephone_number": "801-647-5158"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STANDARD SURGICAL LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-03-05",
        "last_updated": "2018-04-20",
        "status": "A",
        "authorized_official_last_name": "STEADMAN",
        "authorized_official_first_name": "ELLIOT",
        "authorized_official_title_or_position": "SOLE MEMBER",
        "authorized_official_telephone_number": "801-647-5158"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physician Assistant, Surgical",
            "state": "AZ",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "291199",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Surgical Physician Assistant in Litchfield Park, AZ
• Providers in Litchfield Park, AZ by specialty
• Surgical Physician Assistant in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 20, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.