NPIMap

Organization Active NPI

Creekwood Surgery Center, LP

  • Ambulatory Surgical Clinic/Center
  • Kansas City, MO
National Provider Identifier
1154474583
Registry record updated Jan 6, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X
License
107.6 Issued in MO
Legal business name
CREEKWOOD SURGERY CENTER, LP
Practice address
211 NE 54TH St
Suite 100
Kansas City, MO 64118-4337
Phone
(816) 455-4214
Fax
(816) 455-4216
NPI assigned
Jan 19, 2007
Last updated
Jan 6, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 6, 2026

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

Authorized official

Name
Peter Blach
Title
Authorized Official/Officer
Phone
(816) 455-4214

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ambulatory Surgical Clinic/Center 261QA1903X 107.6 MO Primary

Addresses

Primary practice location

211 NE 54TH St
Suite 100
Kansas City, MO 64118-4337

Mailing address

211 NE 54TH St
Suite 100
Kansas City, MO 64118-4337
Phone (816) 455-4214

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL https://esmd.abilitynetwork.com:8291/gateway/documentsubmission/2_0/NhinService/XDRRequest_Service Other Ability Network

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20100204000404 MO Part B Supplier - Ambulatory Surgical Center 1254474844 Practice locations: Kansas City, MO

Care Compare: Ambulatory surgical center

Medicare Care Compare
Listed as
Creekwood Surgery Center LPCCN 26C0001021
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
26D0444162Creekwood Surgery Center211 N E 54TH Street Suite 100, Kansas City, MO 64118Certificate of waiverMay 31, 2027

National Provider Directory

National Provider Directory

Member of 2

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

Locations

211 NE 54th St
Kansas City, MO 64118
Phone (816) 455-2020

Practitioners & affiliated clinicians

Practitioners 38

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 38

NPI Registry JSON

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

{
    "created_epoch": "1169164800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1767657600000",
    "number": "1154474583",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "211 NE 54TH ST",
            "address_2": "SUITE 100",
            "city": "KANSAS CITY",
            "state": "MO",
            "postal_code": "641184337",
            "telephone_number": "816-455-4214",
            "fax_number": "816-455-4216"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "211 NE 54TH ST",
            "address_2": "SUITE 100",
            "city": "KANSAS CITY",
            "state": "MO",
            "postal_code": "641184337",
            "telephone_number": "816-455-4214",
            "fax_number": "816-455-4216"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CREEKWOOD SURGERY CENTER, LP",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-19",
        "last_updated": "2026-01-06",
        "certification_date": "2026-01-06",
        "status": "A",
        "authorized_official_last_name": "BLACH",
        "authorized_official_first_name": "PETER",
        "authorized_official_title_or_position": "AUTHORIZED OFFICIAL/OFFICER",
        "authorized_official_telephone_number": "816-455-4214"
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": "MO",
            "license": "107.6",
            "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": []
}

Other providers in Kansas City, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 6, 2026; 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.