Surgery Center 121 LLC

Primary specialty

Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X

Legal business name

SURGERY CENTER 121 LLC

Practice address

9955 Gillespie Drive Suite 200
Plano, TX 75025

Phone

(972) 403-1110

Fax

(972) 403-1153

NPI assigned

Aug 15, 2018

Organization subpart

No

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

Authorized official

Name

Susan Thomas

Title

Administrator

Phone

(469) 351-7079

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in TX

Enrollment records 1

Listed as

Surgery Center 121CCN 45C0001671

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

Locations

Practitioners 3

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

• Dain B Brooks, MD

  • Ophthalmology Physician
  • Plano, TX
  • NPI 1407860828
  Medicare reassignment NPD
• Parsha Forouzan, MD

  • Ophthalmology Physician
  • Plano, TX
  • NPI 1912433046
  Medicare reassignment NPD
• Mohammad Khurram Kureishy, MD

  • Ophthalmology Physician
  • Plano, TX
  • NPI 1609431923
  NPD (past)

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

{
    "created_epoch": "1534291200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1700611200000",
    "number": "1093295545",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9955 GILLESPIE DRIVE SUITE 200",
            "city": "PLANO",
            "state": "TX",
            "postal_code": "75025",
            "telephone_number": "972-403-1110"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9955 GILLESPIE DRIVE SUITE 200",
            "city": "PLANO",
            "state": "TX",
            "postal_code": "75025",
            "telephone_number": "972-403-1110",
            "fax_number": "972-403-1153"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SURGERY CENTER 121 LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-08-15",
        "last_updated": "2023-11-22",
        "certification_date": "2023-11-22",
        "status": "A",
        "authorized_official_last_name": "THOMAS",
        "authorized_official_first_name": "SUSAN",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "469-351-7079"
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Shravani Surakanti, M.D.
• Suresh Sureddi, M.D.
• Suresh Sureddi MD LLC
• Surgassist Pro LLC
• Surgcenter of Plano LLC
• Surgery Center of Texas LP
• Surgical Anesthesia Consultants, PLLC
• Surgical Associates of Collin County, PLLC
• Surgical PA LLC
• Surgical Specialists of Plano PA

• Ambulatory Surgical Clinic/Center in Plano, TX
• Providers in Plano, 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 22, 2023; 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.