Organization Active NPI

BSC 1 LLC

  • Ambulatory Surgical Clinic/Center
  • Queen Creek, AZ
National Provider Identifier
1114549805
Registry record updated Aug 26, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X
Legal business name
BSC 1 LLC
Practice address
37200 N Gantzel Rd Ste 100
Queen Creek, AZ 85140-7368
Phone
(480) 292-8541
Fax
(480) 508-4617
NPI assigned
May 15, 2020
Last updated
Aug 26, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 26, 2024

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

Authorized official

Name
Aric Burke
Title
Vice President of Manager
Phone
(480) 689-8403

Specialties & licenses 1

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

Addresses

Primary practice location

37200 N Gantzel Rd Ste 100
Queen Creek, AZ 85140-7368

Mailing address

2355 E Camelback Rd Ste 700
Phoenix, AZ 85016-9044
Phone (602) 358-8512

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20200916000812 AZ Part B Supplier - Ambulatory Surgical Center 3577981000 Practice locations: Queen Creek, AZ

Care Compare: Ambulatory surgical center

Medicare Care Compare
Listed as
Banner Surgery Center IronwoodCCN 03C0001430
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
03D2228397BSC 1 LLC37200 N Gantzel Rd Ste 100, Queen Creek, AZ 85140Certificate of waiverJun 24, 2027

National Provider Directory

National Provider Directory

Member of 1

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

Locations

37200 N Gantzel Rd
Ste 100
San Tan Valley, AZ 85140
Phone (480) 219-1010

NPI Registry JSON

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

{
    "created_epoch": "1589500800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1724630400000",
    "number": "1114549805",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2355 E CAMELBACK RD STE 700",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850169044",
            "telephone_number": "602-358-8512"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "37200 N GANTZEL RD STE 100",
            "city": "QUEEN CREEK",
            "state": "AZ",
            "postal_code": "851407368",
            "telephone_number": "480-292-8541",
            "fax_number": "480-508-4617"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BSC 1 LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-05-15",
        "last_updated": "2024-08-26",
        "certification_date": "2024-08-26",
        "status": "A",
        "authorized_official_last_name": "BURKE",
        "authorized_official_first_name": "ARIC",
        "authorized_official_title_or_position": "VICE PRESIDENT OF MANAGER",
        "authorized_official_telephone_number": "480-689-8403"
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Queen Creek, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 26, 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.