Active NPI
McKinley Surgery Center, LLC
- Ambulatory Surgical Clinic/Center
- Fairbanks, AK
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Ambulatory Surgical Clinic/Center
- Legal business name
- MCKINLEY SURGERY CENTER, LLC
- Practice address
- 3745 Geist Rd
Fairbanks, AK 99709-3554 - Phone
- (907) 373-3700
- Fax
- (907) 373-3799
- NPI assigned
- Sep 9, 2022
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Stan James
- Title
- Ceo/Owner
- Phone
- (907) 373-3700
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Ambulatory Surgical Clinic/Center | 261QA1903X | Primary |
Addresses
Primary practice location
3745 Geist Rd
Fairbanks, AK 99709-3554
Mailing address
3765 E. Blue Lupine Dr Ste B
Wasilla, AK 99654
Phone (907) 373-3700
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in AK
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20240416000650 | AK | Part B Supplier - Ambulatory Surgical Center | 9638518228 | Practice locations: Fairbanks, AK |
Ambulatory surgical center certification: CCN 02C0001024
Name & address match This certification has no NPI in the Medicare enrollment files. CMS publishes enrollment files for six facility types only, so it was connected to this NPI by matching the name and address CMS publishes for it.
- Legal name
- McKinley Surgery Center
- Certification status
- Active
- Provider type (POS)
- Ambulatory surgical center
- Participating since
- Dec 11, 2025
- Last certification
- Dec 11, 2025
- Ownership / control type
- Proprietary
- Facility address
- 3745 Geist Road
Fairbanks, AK 99709
Laboratory certificates & supplier records
Derived by NPIMapThese CMS records do not include an NPI. They are shown because their name and street address match this provider’s.
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 02D2274065 | McKinley Surgery Center, LLC | Certificate of waiver | Dec 21, 2026 |
National Provider Directory
National Provider DirectoryMember of 1
Organizations this organization is a member of, according to the National Provider Directory.
-
- Orthopaedic Surgery Physician
- Fairbanks, AK
- NPI 1760938021
Member Of
Locations
3765 E Blue Lupine Dr
Ste B
Wasilla, AK 99654
Practitioners & affiliated clinicians
Practitioners 2
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Psychiatric/Mental Health Registered Nurse
- Anchorage, AK
- NPI 1053918268
-
- Orthopaedic Surgery Physician
- Manhattan, KS
- NPI 1962659060
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1662681600000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1662681600000",
"number": "1063133759",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3765 E. BLUE LUPINE DR STE B",
"city": "WASILLA",
"state": "AK",
"postal_code": "99654",
"telephone_number": "907-373-3700",
"fax_number": "907-373-3799"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3745 GEIST RD",
"city": "FAIRBANKS",
"state": "AK",
"postal_code": "997093554",
"telephone_number": "907-373-3700",
"fax_number": "907-373-3799"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "MCKINLEY SURGERY CENTER, LLC",
"organizational_subpart": "NO",
"enumeration_date": "2022-09-09",
"last_updated": "2022-09-09",
"certification_date": "2022-09-09",
"status": "A",
"authorized_official_last_name": "JAMES",
"authorized_official_first_name": "STAN",
"authorized_official_title_or_position": "CEO/OWNER",
"authorized_official_telephone_number": "907-373-3700"
},
"taxonomies": [
{
"code": "261QA1903X",
"taxonomy_group": "",
"desc": "Clinic/Center, Ambulatory Surgical",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Fairbanks, AK
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 9, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
- 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.