Regency Ambulatory Surgery Center One, LLC

Primary specialty

Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X

Legal business name

REGENCY AMBULATORY SURGERY CENTER ONE, LLC

Practice address

14725 W Mountain View Blvd
Surprise, AZ 85374-2704

Phone

(623) 243-9077

Fax

(623) 271-9826

NPI assigned

Oct 14, 2019

Organization subpart

No

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

Authorized official

Name

Dr. Jason Lee Mussman, MDNPI 1144430182

Title

Ceo/Sole Member

Phone

(623) 243-9077

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in AZ2 enrollments

Enrollment records 2

Ambulatory surgical center certification: CCN 03C0001447

Legal name

ADVANCED AMBULATORY SURGERY CENTER ONE LLC

Certification status

Active

Provider type (POS)

Ambulatory surgical center

Participating since

Oct 25, 2021

Last certification

Oct 25, 2021

Ownership / control type

Proprietary

Facility address

14725 West Mountain View Boulevard, Suite 125
Surprise, AZ 85374

Listed as

Regency Ambulatory Surgery Center One LLCCCN 03C0001431

Medicare certification status

ActiveFrom the Provider of Services file

Practitioners 4

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

• Jason Lee Mussman, M.D.

  • Plastic and Reconstructive Surgery Physician
  • Phoenix, AZ
  • NPI 1144430182
  Medicare reassignment NPD Authorized official
• Ashkaun Shaterian

  • Plastic and Reconstructive Surgery Physician
  • Phoenix, AZ
  • NPI 1679917025
  Medicare reassignment NPD
• Spencer K Michalke, M.D.

  • Plastic and Reconstructive Surgery Physician
  • Fort Myers, FL
  • NPI 1801155064

  AZ

  Medicare reassignment NPD
• Jeanette C. Bannister, PA-C

  • Physician Assistant
  • Goodyear, AZ
  • NPI 1427325638
  Medicare reassignment

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

{
    "created_epoch": "1571011200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1746144000000",
    "number": "1073155834",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10240 W INDIAN SCHOOL RD STE 115",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850375905",
            "telephone_number": "623-243-9077",
            "fax_number": "623-271-9826"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14725 W MOUNTAIN VIEW BLVD",
            "city": "SURPRISE",
            "state": "AZ",
            "postal_code": "853742704",
            "telephone_number": "623-243-9077",
            "fax_number": "623-271-9826"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "REGENCY AMBULATORY SURGERY CENTER ONE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-10-14",
        "last_updated": "2025-05-02",
        "certification_date": "2025-05-02",
        "status": "A",
        "authorized_official_last_name": "MUSSMAN",
        "authorized_official_first_name": "JASON",
        "authorized_official_middle_name": "LEE",
        "authorized_official_title_or_position": "CEO/SOLE MEMBER",
        "authorized_official_telephone_number": "623-243-9077",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Reems Surgery Center LLC
• Drew Aubrey Reese, D.O.
• Reflexion Medical Rejuvenation Center PLLC
• Anamaria Regalado, EDS
• Regency Ambulatory Surgery Center One
• Regency Skin Institute PLLC
• Regency Spa LLC
• Regulators Transportation
• Brooke Rehm
• Abbigale Rae Rehurek

• Ambulatory Surgical Clinic/Center in Surprise, AZ
• Providers in Surprise, AZ by specialty
• Ambulatory Surgical Clinic/Center in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 2, 2025; 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.

Verify at the official NPI Registry.