Organization Active NPI

Tri-City Surgical Centers, LLC

  • Ambulatory Surgical Clinic/Center
  • Mesa, AZ
National Provider Identifier
1083382154
Registry record updated Sep 2, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X
Legal business name
TRI-CITY SURGICAL CENTERS, LLC
Practice address
143 S 63Rd Street
Mesa, AZ 85206
Phone
(480) 835-6100
NPI assigned
Sep 2, 2021
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 2, 2021

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

Authorized official

Name
Jaskamal Kahlon, MDNPI 1093783953
Title
Authorized Official
Phone
(480) 835-6100

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

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

Addresses

Primary practice location

143 S 63Rd Street
Mesa, AZ 85206

Mailing address

6343 E Main St Ste 12
Mesa, AZ 85205-8955
Phone (480) 835-6100

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20220330001566 AZ Part B Supplier - Ambulatory Surgical Center 8022404102 Practice locations: Mesa, AZ

Care Compare: Ambulatory surgical center

Medicare Care Compare
Listed as
Tri City Surgical Centers LLCCCN 03C0001462
Medicare certification status
ActiveFrom the Provider of Services file

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
03D2248660Tri-City Surgical Centers143 S 63Rd St, Mesa, AZ 85206AccreditationFeb 27, 2027

National Provider Directory

National Provider Directory

Locations

143 S 63rd St
Ste 101
Mesa, AZ 85206

Practitioners & affiliated clinicians

Practitioners 3

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

NPI Registry JSON

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

{
    "created_epoch": "1630540800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1630540800000",
    "number": "1083382154",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6343 E MAIN ST STE 12",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852058955",
            "telephone_number": "480-835-6100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "143 S 63RD STREET",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "85206",
            "telephone_number": "480-835-6100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TRI-CITY SURGICAL CENTERS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-09-02",
        "last_updated": "2021-09-02",
        "certification_date": "2021-08-17",
        "status": "A",
        "authorized_official_last_name": "KAHLON",
        "authorized_official_first_name": "JASKAMAL",
        "authorized_official_title_or_position": "AUTHORIZED OFFICIAL",
        "authorized_official_telephone_number": "480-835-6100",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mesa, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 2, 2021; 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.