Organization Active NPI

Northeast Surgicare, LLC

  • Ambulatory Surgical Clinic/Center
  • Lakewood, NJ
National Provider Identifier
1053566513
Registry record updated Jun 30, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X
Legal business name
NORTHEAST SURGICARE, LLC
Practice address
475 Route 70 Ste 203
Lakewood, NJ 08701-5897
Phone
(732) 714-0070
NPI assigned
Nov 25, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 30, 2017

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

Authorized official

Name
Dr. Dimitrios Christos Lambrou, DC
Title
Co-Owner
Phone
(732) 714-0070

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ambulatory Surgical Clinic/Center 261QA1903X Primary

Addresses

Primary practice location

475 Route 70 Ste 203
Lakewood, NJ 08701-5897

Mailing address

475 Route 70 Ste 203
Lakewood, NJ 08701-5897

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20171020000722 NJ Part B Supplier - Ambulatory Surgical Center 2567738461 Practice locations: Lakewood, NJ

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Care Compare: Ambulatory surgical center

Medicare Care Compare
Listed as
Northeast Surgicare LLCCCN 31C0001209
Medicare certification status
ActiveFrom the Provider of Services file

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
31D2135306Northeast Surgicare LLC475 Route 70, Lakewood, NJ 08701Certificate of waiverAug 17, 2027

National Provider Directory

National Provider Directory
Tax ID family
Northeast Surgi-Care LLC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1227571200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1498780800000",
    "number": "1053566513",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "475 ROUTE 70 STE 203",
            "city": "LAKEWOOD",
            "state": "NJ",
            "postal_code": "087015897"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "475 ROUTE 70 STE 203",
            "city": "LAKEWOOD",
            "state": "NJ",
            "postal_code": "087015897",
            "telephone_number": "732-714-0070"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTHEAST SURGICARE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-11-25",
        "last_updated": "2017-06-30",
        "status": "A",
        "authorized_official_last_name": "LAMBROU",
        "authorized_official_first_name": "DIMITRIOS",
        "authorized_official_middle_name": "CHRISTOS",
        "authorized_official_title_or_position": "CO-OWNER",
        "authorized_official_telephone_number": "732-714-0070",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lakewood, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 30, 2017; 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.