Organization Active NPI

Cadillac Surgery Center, LLC

  • Surgery Physician
  • Cadillac, MI
National Provider Identifier
1154208445
Registry record updated Aug 19, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
Legal business name
CADILLAC SURGERY CENTER, LLC
Practice address
7665 S US 131 Hwy
Cadillac, MI 49601
Phone
(231) 876-7411
NPI assigned
Aug 19, 2025
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 19, 2025

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

Authorized official

Name
Peter Edward Marinoff
Title
President/Ceo South Reigon
Phone
(231) 352-2285

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208600000X Primary

Addresses

Primary practice location

7665 S US 131 Hwy
Cadillac, MI 49601

Mailing address

7665 S US 131 Hwy
Cadillac, MI 49601
Phone (231) 876-7411

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
23D2338300Cadillac Surgery Center, LLC7665 US Highway 131 S, Cadillac, MI 49601Certificate of waiverFeb 8, 2028

National Provider Directory

National Provider Directory

Locations

7665 US Highway 131 S
Cadillac, MI 49601
Phone (231) 876-7411

NPI Registry JSON

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

{
    "created_epoch": "1755561600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1755561600000",
    "number": "1154208445",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7665 S US 131 HWY",
            "city": "CADILLAC",
            "state": "MI",
            "postal_code": "49601",
            "telephone_number": "231-876-7411"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7665 S US 131 HWY",
            "city": "CADILLAC",
            "state": "MI",
            "postal_code": "49601",
            "telephone_number": "231-876-7411"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CADILLAC SURGERY CENTER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-08-19",
        "last_updated": "2025-08-19",
        "certification_date": "2025-08-14",
        "status": "A",
        "authorized_official_last_name": "MARINOFF",
        "authorized_official_first_name": "PETER",
        "authorized_official_middle_name": "EDWARD",
        "authorized_official_title_or_position": "PRESIDENT/CEO SOUTH REIGON",
        "authorized_official_telephone_number": "231-352-2285"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cadillac, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 19, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • 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.