Spicewood Surgery Center LLC

Primary specialty

Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X

Legal business name

SPICEWOOD SURGERY CENTER LLC

Practice address

13617 Caldwell Dr Ste 200
Austin, TX 78750-2324

Phone

(512) 637-5563

NPI assigned

Apr 4, 2019

Organization subpart

No

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

Authorized official

Name

Peter Blach, RN

Title

Authorized Official

Phone

(713) 343-0832

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Spicewood Surgery Center Doing business as

Electronic endpoints 2

Medicare fee-for-service enrollment

Enrolled in TX

Enrollment records 1

Listed as

Spicewood Surgery CenterCCN 45C0001687

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

Member of 1

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

• VHS San Antonio Partners LLC

  • Psychiatric Hospital Unit
  • San Antonio, TX
  • NPI 1487633509

  Member Of

  NPD member

Locations

Practitioners 3

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

• Ashley Heuss, CRNA

  • Certified Registered Nurse Anesthetist
  • Austin, TX
  • NPI 1669878187
  NPD
• Mahan Ostadian, D.O

  • Pain Medicine (Anesthesiology) Physician
  • Austin, TX
  • NPI 1821263005
  NPD
• Clement Carol Yeh, MD

  • Anesthesiology Physician
  • Austin, TX
  • NPI 1275744435
  NPD

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

{
    "created_epoch": "1554336000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1732060800000",
    "number": "1083176309",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13617 CALDWELL DR STE 200",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787502324",
            "telephone_number": "512-637-5563"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13617 CALDWELL DR STE 200",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787502324",
            "telephone_number": "512-637-5563"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SPICEWOOD SURGERY CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-04-04",
        "last_updated": "2024-11-20",
        "certification_date": "2024-11-20",
        "status": "A",
        "authorized_official_last_name": "BLACH",
        "authorized_official_first_name": "PETER",
        "authorized_official_title_or_position": "AUTHORIZED OFFICIAL",
        "authorized_official_telephone_number": "713-343-0832",
        "authorized_official_credential": "RN"
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1083176309",
            "state": "TX"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "office@treatpainnow.com",
            "affiliation": "N",
            "endpointDescription": "Ambulatory Surgical Center",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "13617 Caldwell Drive",
            "address_2": "Suite 230",
            "city": "Austin",
            "state": "TX",
            "country_code": "US",
            "postal_code": "78750",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://esmd.abilitynetwork.com:8291/gateway/documentsubmission/2_0/NhinService/XDRRequest_Service",
            "affiliation": "Y",
            "endpointDescription": "2.16.840.1.113883.3.667.2",
            "affiliationName": "Ability Network",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "CMS esMD eMDR",
            "address_1": "100 N 6th St Ste 900A",
            "city": "Minneapolis",
            "state": "MN",
            "country_code": "US",
            "postal_code": "554031516",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Spicewood Surgery Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Serie Spicer, PHD
• Spicewood Anesthesia Associates
• Spicewood Dermatology, P.a.
• Spicewood Outpatient LLC
• Spicewood Springs Dental Center
• Brooke Spickler, M.S., CCC-SLP
• Justin Spiegelman, DMD
• Rudie Spigarelli, PT
• Katie Lynn Spillar, LMFT
• Lynn L Spillar, M.D.

• Ambulatory Surgical Clinic/Center in Austin, TX
• Providers in Austin, TX by specialty
• Ambulatory Surgical Clinic/Center in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 20, 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.