Advanced Surgery Center of Northern Louisiana LLC
Organization Active NPI Ambulatory Surgical Clinic/Center · Monroe, LA
NPI 1104181247 · NPPES record last updated Jan 29, 2026
Key facts
- NPI
- 1104181247
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Ambulatory Surgical Clinic/Center 261QA1903X
- Legal business name
- ADVANCED SURGERY CENTER OF NORTHERN LOUISIANA LLC
- Practice address
- 1601 Louisville Ave
Monroe, LA 71201 - Phone
- (318) 272-2214
- NPI assigned
- Jul 4, 2012
- Organization subpart
- No
Authorized official
- Name
- Peter Blach, BLACH
- Title
- Authorize Offical
- Phone
- (713) 343-0832
Member of 2
Medicare Care Compare: Ambulatory surgical center
- Listed as
- Advanced Surgery Center of Northern Louisiana LLC
Laboratory certificates & supplier records
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 19D2046779 | Advanced Surgery Center of Northern Louisiana | Certificate of waiver | Sep 11, 2026 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in LA
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20121108000410 | LA | Part B Supplier - Ambulatory Surgical Center | 9537310180 | Practice locations: Monroe, LA |
National Provider Directory
Locations
1601 Louisville Ave
Monroe, LA 71201
Phone (318) 998-5555
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Ambulatory Surgical Clinic/Center | 261QA1903X | Yes |
Addresses
Primary practice location
1601 Louisville Ave
Monroe, LA 71201
Mailing address
1601 Louisville Ave
Monroe, LA 71201-6027
Phone (318) 998-5555
Electronic endpoints
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| CONNECT URL | https://esmd.abilitynetwork.com:8291/gateway/documentsubmission/2_0/NhinService/XDRRequest_Service | Other | Ability Network |
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All providers in Monroe, LA · Ambulatory Surgical Clinic/Center in Louisiana
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 29, 2026. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.