Las Vegas Regional Surgery Center, LP

Primary specialty

Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X

License

468ASC-15 Issued in NV

Legal business name

LAS VEGAS REGIONAL SURGERY CENTER, LP

Practice address

3560 E Flamingo Rd
Las Vegas, NV 89121-5044

Phone

(702) 454-8712

NPI assigned

Aug 14, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Issac Verbukh, M.D.

Title

President

Phone

(310) 301-8329

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Ambulatory surgical center certification: CCN 29C0001023

Legal name

LAS VEGAS REGIONAL SURGERY CENTER LP

Certification status

Active

Provider type (POS)

Ambulatory surgical center

Participating since

Sep 19, 2003

Last certification

Aug 16, 2019

Ownership / control type

Proprietary

Facility address

3560 E Flamingo Road Ste 105
Las Vegas, NV 89121

Locations

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

{
    "created_epoch": "1187049600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1277078400000",
    "number": "1073705992",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4333 ADMIRALTY WAY",
            "address_2": "WEST HELIX #9",
            "city": "MARINA DEL REY",
            "state": "CA",
            "postal_code": "902925469",
            "telephone_number": "310-301-8329",
            "fax_number": "310-301-8329"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3560 E FLAMINGO RD",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891215044",
            "telephone_number": "702-454-8712"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LAS VEGAS REGIONAL SURGERY CENTER, LP",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-08-14",
        "last_updated": "2010-06-21",
        "status": "A",
        "authorized_official_last_name": "VERBUKH",
        "authorized_official_first_name": "ISSAC",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "310-301-8329",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": "NV",
            "license": "468ASC-15",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Ambulatory Surgical Clinic/Center in Las Vegas, NV
• Providers in Las Vegas, NV by specialty
• Ambulatory Surgical Clinic/Center in Nevada

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 21, 2010; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.