North Coast Surgery Center, LLC

Primary specialty

Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X

License

0775AS Issued in OH

Legal business name

NORTH COAST SURGERY CENTER, LLC

Practice address

1170 E Broad St
Suite 104
Elyria, OH 44035-6351

Phone

(440) 366-6029

Fax

(440) 366-6064

NPI assigned

May 10, 2006

Organization subpart

No

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

Authorized official

Name

Dr. George Costaras, D.P.M.

Title

President

Phone

(440) 366-6029

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Ambulatory surgical center certification: CCN 36C0001214

Legal name

NORTH COAST SURGERY CENTER, LLC

Certification status

Active

Provider type (POS)

Ambulatory surgical center

Participating since

Sep 28, 2006

Last certification

Jun 22, 2017

Ownership / control type

Proprietary

Facility address

1170 East Broad Street, Suite 104
Elyria, OH 44035

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

{
    "created_epoch": "1147219200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1259884800000",
    "number": "1174572606",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1170 E BROAD ST",
            "address_2": "SUITE 104",
            "city": "ELYRIA",
            "state": "OH",
            "postal_code": "440356351",
            "telephone_number": "440-366-6029",
            "fax_number": "440-366-6064"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1170 E BROAD ST",
            "address_2": "SUITE 104",
            "city": "ELYRIA",
            "state": "OH",
            "postal_code": "440356351",
            "telephone_number": "440-366-6029",
            "fax_number": "440-366-6064"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTH COAST SURGERY CENTER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-10",
        "last_updated": "2009-12-04",
        "status": "A",
        "authorized_official_last_name": "COSTARAS",
        "authorized_official_first_name": "GEORGE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "440-366-6029",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.P.M."
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": "OH",
            "license": "0775AS",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Norman Floro Medical, Inc.
• North Coast Chiropractic
• North Coast Gastroenterology, Inc
• North Coast Nephrology, Inc
• North Coast Sleep Solutions LLC
• North Ohio Heart Inc
• North Ohio Surgery, Inc.
• North Ridge Chiropractic, Inc
• Northcoast Pain Specialists LLC
• John Northcott, CDCA

• Ambulatory Surgical Clinic/Center in Elyria, OH
• Providers in Elyria, OH by specialty
• Ambulatory Surgical Clinic/Center in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 4, 2009; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.