Apollo Surgery Center LLC

Primary specialty

Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X

Legal business name

APOLLO SURGERY CENTER LLC

Practice address

43944 15TH Street W
Suite 101
Lancaster, CA 93534

Phone

(661) 579-4700

NPI assigned

Jul 19, 2022

Organization subpart

No

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

Authorized official

Name

Dr. Vivaik Tyagi, MDNPI 1073612545

Title

Chairman, Governing Body

Phone

(661) 579-4700

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Listed as

Apollo Surgery Center LLCCCN 55C0001131

Medicare certification status

ActiveFrom the Provider of Services file

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 2

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

• Vivaik Tyagi, M.D.

  • Gastroenterology Physician
  • Lancaster, CA
  • NPI 1073612545
  NPD Authorized official
• Kumaravel Perumalsamy, M.D.

  • Gastroenterology Physician
  • Lancaster, CA
  • NPI 1851484323
  NPD (past)

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

{
    "created_epoch": "1658188800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1663891200000",
    "number": "1174258602",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "43944 15TH STREET W",
            "address_2": "SUITE 101",
            "city": "LANCASTER",
            "state": "CA",
            "postal_code": "93534",
            "telephone_number": "661-579-4700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "43944 15TH STREET W",
            "address_2": "SUITE 101",
            "city": "LANCASTER",
            "state": "CA",
            "postal_code": "93534",
            "telephone_number": "661-579-4700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "APOLLO SURGERY CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-07-19",
        "last_updated": "2022-09-23",
        "certification_date": "2022-09-23",
        "status": "A",
        "authorized_official_last_name": "TYAGI",
        "authorized_official_first_name": "VIVAIK",
        "authorized_official_title_or_position": "CHAIRMAN, GOVERNING BODY",
        "authorized_official_telephone_number": "661-579-4700",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Ambulatory Surgical Clinic/Center in Lancaster, CA
• Providers in Lancaster, CA by specialty
• Ambulatory Surgical Clinic/Center in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 23, 2022; 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.