NPIMap

Organization Active NPI

Northtowns Ambulatory Surgery Center, LLC

  • Ambulatory Surgical Clinic/Center
  • Williamsville, NY
National Provider Identifier
1073384855
Registry record updated Apr 8, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X
Legal business name
NORTHTOWNS AMBULATORY SURGERY CENTER, LLC
Practice address
111 N Maplemere Rd
Williamsville, NY 14221-3181
Phone
(716) 817-0450
Fax
(716) 817-0394
NPI assigned
Jan 11, 2024
Last updated
Apr 8, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 8, 2025

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

Authorized official

Name
Mr. Ronald Scott Mornelli
Title
Chief Executive Officer
Phone
(716) 817-0450

Specialties & licenses 1

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

Addresses

Primary practice location

111 N Maplemere Rd
Williamsville, NY 14221-3181

Mailing address

111 N Maplemere Rd Ste 170
Williamsville, NY 14221-3182
Phone (716) 817-0405

Other names 1

  • Maplemere Ventures, LLC Former legal business name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20240403001816 NY Part B Supplier - Ambulatory Surgical Center 2860830379 Receives reassigned benefits from 20 practitioners
Practice locations: Williamsville, NY

Care Compare: Ambulatory surgical center

Medicare Care Compare
Listed as
Northtowns Ambulatory Surgery Center LLCCCN 33C0001220
Medicare certification status
ActiveFrom the Provider of Services file

National Provider Directory

National Provider Directory

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

Locations

111 N Maplemere Rd
Williamsville, NY 14221
Phone (716) 636-8284

Practitioners & affiliated clinicians

Practitioners 25

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 25

NPI Registry JSON

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

{
    "created_epoch": "1704931200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1744070400000",
    "number": "1073384855",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "111 N MAPLEMERE RD STE 170",
            "city": "WILLIAMSVILLE",
            "state": "NY",
            "postal_code": "142213182",
            "telephone_number": "716-817-0405",
            "fax_number": "716-817-0394"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 N MAPLEMERE RD",
            "city": "WILLIAMSVILLE",
            "state": "NY",
            "postal_code": "142213181",
            "telephone_number": "716-817-0450",
            "fax_number": "716-817-0394"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTHTOWNS AMBULATORY SURGERY CENTER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-01-11",
        "last_updated": "2025-04-08",
        "certification_date": "2025-04-08",
        "status": "A",
        "authorized_official_last_name": "MORNELLI",
        "authorized_official_first_name": "RONALD",
        "authorized_official_middle_name": "SCOTT",
        "authorized_official_title_or_position": "CHIEF EXECUTIVE OFFICER",
        "authorized_official_telephone_number": "716-817-0450",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Maplemere Ventures, LLC",
            "code": "4",
            "type": "Former Legal Business Name"
        },
        {
            "organization_name": "Maplemere Ventures, LLC",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in Williamsville, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 8, 2025; 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.