Active NPI
Everett Road ASC, LLC
- Ambulatory Surgical Clinic/Center
- Albany, NY
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Ambulatory Surgical Clinic/Center
- Legal business name
- EVERETT ROAD ASC, LLC
- Practice address
- 123 Everett Rd
Albany, NY 12205-1407 - Phone
- (518) 489-2663
- Fax
- (518) 689-3881
- NPI assigned
- Jun 24, 2019
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Frank Congiusta, MD
- Title
- Medical Director
- Phone
- (518) 453-9088
Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Ambulatory Surgical Clinic/Center | 261QA1903X | Primary |
Addresses
Primary practice location
123 Everett Rd
Albany, NY 12205-1407
Mailing address
121 Everett Rd
Albany, NY 12205-1474
Phone (518) 489-2663
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 06200059 | Medicaid | NY |
Other names 1
- Everett Road Surgery Center
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NY
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20200109000572 | NY | Part B Supplier - Ambulatory Surgical Center | 0648605204 | Practice locations: Albany, NY |
Care Compare: Ambulatory surgical center
Medicare Care Compare- Listed as
- Everett Rd Surgery Center
- Medicare certification status
- Active
Laboratory certificates & supplier records
Derived by NPIMapThese CMS records do not include an NPI. They are shown because their name and street address match this provider’s.
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 33D2172394 | Everett Road Surgery Center | Certificate of waiver | Mar 26, 2027 |
National Provider Directory
National Provider DirectoryMember of 2
Organizations this organization is a member of, according to the National Provider Directory.
-
- Internal Medicine Physician
- Rensselaer, NY
- NPI 1487725750
Member Of
Locations
123 Everett Rd
Albany, NY 12205
Phone (518) 701-2000
Practitioners & affiliated clinicians
Practitioners 1
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Orthopaedic Surgery Physician
- Albany, NY
- NPI 1245280403
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1561334400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1753228800000",
"number": "1164083911",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "121 EVERETT RD",
"city": "ALBANY",
"state": "NY",
"postal_code": "122051474",
"telephone_number": "518-489-2663",
"fax_number": "518-689-3881"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "123 EVERETT RD",
"city": "ALBANY",
"state": "NY",
"postal_code": "122051407",
"telephone_number": "518-489-2663",
"fax_number": "518-689-3881"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "EVERETT ROAD ASC, LLC",
"organizational_subpart": "NO",
"enumeration_date": "2019-06-24",
"last_updated": "2025-07-23",
"certification_date": "2025-07-23",
"status": "A",
"authorized_official_last_name": "CONGIUSTA",
"authorized_official_first_name": "FRANK",
"authorized_official_title_or_position": "MEDICAL DIRECTOR",
"authorized_official_telephone_number": "518-453-9088",
"authorized_official_credential": "MD"
},
"taxonomies": [
{
"code": "261QA1903X",
"taxonomy_group": "",
"desc": "Clinic/Center, Ambulatory Surgical",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "06200059",
"state": "NY"
}
],
"endpoints": [],
"other_names": [
{
"organization_name": "Everett Road Surgery Center",
"code": "3",
"type": "Doing Business As"
},
{
"organization_name": "Everett Road Surgery Center",
"code": "3",
"type": "Doing Business As"
}
]
}
Other providers in Albany, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 23, 2025; 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.