NPIMap

Organization Active NPI

Surgery Center of Lawrenceville

  • Ambulatory Surgical Clinic/Center
  • Lawrenceville, GA
National Provider Identifier
1083114995
Registry record updated Jan 7, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X
Legal business name
SURGERY CENTER OF LAWRENCEVILLE
Practice address
501 Crownpointe Way
Lawrenceville, GA 30046-7702
Phone
(678) 344-8900
Fax
(678) 666-5201
NPI assigned
Feb 16, 2018
Last updated
Jan 7, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 7, 2025

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

Authorized official

Name
Beemal Shah
Title
Ceo
Phone
(706) 951-8657

Specialties & licenses 1

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

Addresses

Primary practice location

501 Crownpointe Way
Lawrenceville, GA 30046-7702

Mailing address

1551 Janmar Rd
Snellville, GA 30078-5606
Phone (678) 344-8900

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20180910001909 GA Part B Supplier - Ambulatory Surgical Center 7517217706 Practice locations: Lawrenceville, GA

Care Compare: Ambulatory surgical center

Medicare Care Compare
Listed as
Surgery Center of LawrencevilleCCN 11C0001494
Medicare certification status
ActiveFrom the Provider of Services file

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 55

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 55

NPI Registry JSON

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

{
    "created_epoch": "1518739200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1736208000000",
    "number": "1083114995",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1551 JANMAR RD",
            "city": "SNELLVILLE",
            "state": "GA",
            "postal_code": "300785606",
            "telephone_number": "678-344-8900",
            "fax_number": "678-666-5201"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "501 CROWNPOINTE WAY",
            "city": "LAWRENCEVILLE",
            "state": "GA",
            "postal_code": "300467702",
            "telephone_number": "678-344-8900",
            "fax_number": "678-666-5201"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SURGERY CENTER OF LAWRENCEVILLE",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-02-16",
        "last_updated": "2025-01-07",
        "certification_date": "2025-01-07",
        "status": "A",
        "authorized_official_last_name": "SHAH",
        "authorized_official_first_name": "BEEMAL",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "706-951-8657"
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lawrenceville, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 7, 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.