Northern Ohio Surgery Center, LLC

Primary specialty

Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X

Legal business name

NORTHERN OHIO SURGERY CENTER, LLC

Practice address

300 Allen Bradley Dr Ste 100
Mayfield Heights, OH 44124-6130

Phone

(216) 353-6959

Fax

(216) 586-2647

NPI assigned

Aug 3, 2021

Organization subpart

No

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

Authorized official

Name

Jennifer Baldock

Title

Officer and Authorized Official

Phone

(615) 234-5954

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in OH

Enrollment records 1

Listed as

Northern Ohio Surgery Center LLCCCN 36C0001195

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

Member of 1

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

• Ohiohealth Corporation

  • General Acute Care Hospital
  • Columbus, OH
  • NPI 1255377149

  Member Of

  NPD member

Locations

Practitioners 2

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

• Reuben Gobezie, MD

  • Orthopaedic Surgery Physician
  • Cleveland, OH
  • NPI 1295786770
  NPD
• Mark R Grubb, MD

  • Orthopaedic Surgery Physician
  • Cleveland, OH
  • NPI 1134111768
  NPD (past)

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

{
    "created_epoch": "1627948800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1756166400000",
    "number": "1043984248",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 ALLEN BRADLEY DR STE 100",
            "city": "MAYFIELD HEIGHTS",
            "state": "OH",
            "postal_code": "441246130",
            "telephone_number": "216-353-6959",
            "fax_number": "216-586-2647"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 ALLEN BRADLEY DR STE 100",
            "city": "MAYFIELD HEIGHTS",
            "state": "OH",
            "postal_code": "441246130",
            "telephone_number": "216-353-6959",
            "fax_number": "216-586-2647"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTHERN OHIO SURGERY CENTER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-08-03",
        "last_updated": "2025-08-26",
        "certification_date": "2025-08-26",
        "status": "A",
        "authorized_official_last_name": "BALDOCK",
        "authorized_official_first_name": "JENNIFER",
        "authorized_official_title_or_position": "OFFICER AND AUTHORIZED OFFICIAL",
        "authorized_official_telephone_number": "615-234-5954"
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "1233AS",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0468167",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Allison Nicholl, APRN
• Kara Marie Nicodemus, CNP, APRN
• Ellen Nicole Niemiec, PA-C
• Jameson P. Nolin
• Northern Ohio Medical Specialists, LLC
• Leah T Nye, FNP-BC
• Laura Holmes O'Connor, MD
• Occupational Health Consultants, LLC
• Ohio CVS Stores LLC
• Ohio CVS Stores LLC

• Ambulatory Surgical Clinic/Center in Mayfield Heights, OH
• Providers in Mayfield Heights, OH by specialty
• Ambulatory Surgical Clinic/Center in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 26, 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.