FW Specialty Surgicare, LLC

Primary specialty

Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X

Legal business name

FW SPECIALTY SURGICARE, LLC

Practice address

2001 Cooper St
Fort Worth, TX 76104-2529

Phone

(817) 339-6991

Fax

(817) 678-4601

NPI assigned

Jul 22, 2022

Organization subpart

No

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

Authorized official

Name

Monica Perry Murphy, RN

Title

Clinical Director

Phone

(682) 800-1099

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in TX

Enrollment records 1

Ambulatory surgical center certification: CCN 45C0451262

Legal name

FW SPECIALTY SURGICARE LLC

Certification status

Active

Provider type (POS)

Ambulatory surgical center

Participating since

Jul 13, 2023

Last certification

Jul 13, 2023

Ownership / control type

Proprietary

Facility address

2001 Cooper Street
Fort Worth, TX 76104

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Richard Chun-Hsien Chu, D.O.

  • Specialist
  • Fort Worth, TX
  • NPI 1164728044

  Ophthalmology

  NPD

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

{
    "created_epoch": "1658448000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1684195200000",
    "number": "1174258107",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2001 COOPER ST",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761042529",
            "telephone_number": "817-339-6991",
            "fax_number": "817-678-4601"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2001 COOPER ST",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761042529",
            "telephone_number": "817-339-6991",
            "fax_number": "817-678-4601"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FW SPECIALTY SURGICARE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-07-22",
        "last_updated": "2023-05-16",
        "certification_date": "2023-05-02",
        "status": "A",
        "authorized_official_last_name": "MURPHY",
        "authorized_official_first_name": "MONICA",
        "authorized_official_middle_name": "PERRY",
        "authorized_official_title_or_position": "CLINICAL DIRECTOR",
        "authorized_official_telephone_number": "682-800-1099",
        "authorized_official_credential": "RN"
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• FWM Healthcare, LLC Dba Ft. Worth Manor
• FWS PLLC.
• Fyatt Healthcare
• G Ives Nutrition Therapy LLC
• Dion Anthony Gabaldon, CRNA, DHA

• Ambulatory Surgical Clinic/Center in Fort Worth, TX
• Providers in Fort Worth, TX by specialty
• Ambulatory Surgical Clinic/Center in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 16, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
• 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.