Susitna Surgery Center LLC

Primary specialty

Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X

Legal business name

SUSITNA SURGERY CENTER LLC

Practice address

2490 S Woodworth Loop Ste 100
Palmer, AK 99645-7410

Phone

(907) 861-6540

Fax

(907) 861-6309

NPI assigned

Jul 10, 2018

Organization subpart

No

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

Authorized official

Name

Kristy Music

Title

Ao-Director, Provider Enrollment

Phone

(615) 465-7377

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in AK

Enrollment records 1

Listed as

Susitna Surgery Center LLCCCN 02C0001018

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

Practitioners 1

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

• Tak Ming Ko, MD

  • Surgery Physician
  • Palmer, AK
  • NPI 1003995713
  NPD (past)

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

{
    "created_epoch": "1531180800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1724198400000",
    "number": "1073009304",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2490 S WOODWORTH LOOP STE 100",
            "city": "PALMER",
            "state": "AK",
            "postal_code": "996457410",
            "telephone_number": "907-861-5640"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2490 S WOODWORTH LOOP STE 100",
            "city": "PALMER",
            "state": "AK",
            "postal_code": "996457410",
            "telephone_number": "907-861-6540",
            "fax_number": "907-861-6309"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUSITNA SURGERY CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-07-10",
        "last_updated": "2024-08-21",
        "certification_date": "2024-08-21",
        "status": "A",
        "authorized_official_last_name": "MUSIC",
        "authorized_official_first_name": "KRISTY",
        "authorized_official_title_or_position": "AO-DIRECTOR, PROVIDER ENROLLMENT",
        "authorized_official_telephone_number": "615-465-7377"
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sullivan Health Services LLC
• Joseph Sullivan, D.C.
• Summit Family Practice,LLC
• Summit Psychiatry Associates
• Summit Psychiatry Associates
• Terrence F Svoboda, M.A.
• Roger Lynn Swingle, MD
• Tak-Ming Ko MD, LLC
• Amanda Jo Taylor, D.V.M
• Brent Taylor, MD

• Ambulatory Surgical Clinic/Center in Palmer, AK
• Providers in Palmer, AK by specialty
• Ambulatory Surgical Clinic/Center in Alaska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 21, 2024; 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.