Great Lakes Surgical Suites, LLC

Primary specialty

Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X

Legal business name

GREAT LAKES SURGICAL SUITES, LLC

Doing business as

Great Lakes Surgical Suites

Practice address

9200 Calumet Ave Ste N500
Munster, IN 46321-2849

Phone

(219) 513-9955

Fax

(219) 513-9373

NPI assigned

Jun 18, 2017

Last updated

Oct 7, 2024By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Christopher Hartshorn

Title

Officer/Authorized Official

Phone

(314) 800-2017

Specialties & licenses 1

Addresses

Other names 1

• Great Lakes Surgical Suites Doing business as

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in IN

Enrollment records 1

Listed as

Great Lakes Surgical Suites LLC Dba Great Lakes Surgical SuitesCCN 15C0001202

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

  dba Baptist Health System

  • Rehabilitation Hospital Unit
  • San Antonio, TX
  • NPI 1124007240

  Member Of

  NPD member

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

{
    "created_epoch": "1497744000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1728259200000",
    "number": "1093245458",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14201 DALLAS PKWY",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752542916",
            "telephone_number": "219-513-9955",
            "fax_number": "219-513-9373"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9200 CALUMET AVE STE N500",
            "city": "MUNSTER",
            "state": "IN",
            "postal_code": "463212849",
            "telephone_number": "219-513-9955",
            "fax_number": "219-513-9373"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GREAT LAKES SURGICAL SUITES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-06-18",
        "last_updated": "2024-10-07",
        "certification_date": "2024-10-07",
        "status": "A",
        "authorized_official_last_name": "HARTSHORN",
        "authorized_official_first_name": "CHRISTOPHER",
        "authorized_official_title_or_position": "OFFICER/AUTHORIZED OFFICIAL",
        "authorized_official_telephone_number": "314-800-2017"
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "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": "Great Lakes Surgical Suites",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Great Lakes Surgical Suites",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Neil Gorski, PHARMD
• Emil H Govani, PHARMD
• Christina Graham, NP
• Cassondra Grahovac, FNP-C
• Sandra J Grano-Vrbanoff, LCSW
• Alecia Green, FNP-BC
• Mitchell Wayne Green, D.C.
• Sierra N Green, PMHNP-BC
• Catherine Elizabeth Gregori
• Tyler Gress, DC

• Ambulatory Surgical Clinic/Center in Munster, IN
• Providers in Munster, IN by specialty
• Ambulatory Surgical Clinic/Center in Indiana

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