Organization Active NPI

Gila River Surgical Center LLC

  • Ambulatory Surgical Clinic/Center
  • Phoenix, AZ
National Provider Identifier
1053927210
Registry record updated Feb 24, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X
Legal business name
GILA RIVER SURGICAL CENTER LLC
Practice address
2340 W Parkside LN Ste H107
Phoenix, AZ 85027-1274
Phone
(602) 237-6340
NPI assigned
Sep 22, 2020
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 24, 2022

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

Authorized official

Name
Thomas Moshiri
Title
Manager
Phone
(602) 354-5310

Specialties & licenses 1

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

Addresses

Primary practice location

2340 W Parkside LN Ste H107
Phoenix, AZ 85027-1274

Mailing address

21001 N Tatum Blvd Ste 1630-606
Phoenix, AZ 85050-4242

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1600732800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1645660800000",
    "number": "1053927210",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21001 N TATUM BLVD STE 1630-606",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850504242"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2340 W PARKSIDE LN STE H107",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850271274",
            "telephone_number": "602-237-6340"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GILA RIVER SURGICAL CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-09-22",
        "last_updated": "2022-02-24",
        "certification_date": "2022-02-24",
        "status": "A",
        "authorized_official_last_name": "MOSHIRI",
        "authorized_official_first_name": "THOMAS",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "602-354-5310"
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Phoenix, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 24, 2022; 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.