NPIMap

Organization Active NPI

Bel Clair Ambulatory Surgical Treatment Center, LTD.

  • Ambulatory Surgical Clinic/Center
  • Belleville, IL
National Provider Identifier
1174601223
Registry record updated Jul 30, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X
License
7001811 Issued in IL
Legal business name
BEL CLAIR AMBULATORY SURGICAL TREATMENT CENTER, LTD.
Practice address
325 W Lincoln St
Belleville, IL 62220-1921
Phone
(618) 235-2299
Fax
(618) 235-2556
NPI assigned
Nov 2, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 30, 2008

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

Authorized official

Name
Mr. David Russell Horace
Title
Administrator
Phone
(618) 235-2299

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ambulatory Surgical Clinic/Center 261QA1903X 7001811 IL Primary

Addresses

Primary practice location

325 W Lincoln St
Belleville, IL 62220-1921

Mailing address

325 W Lincoln St
Belleville, IL 62220-1921
Phone (618) 235-2299

Other names 1

  • BEL CLAIR SURGICAL CENTER Other name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20111208000454 IL Part B Supplier - Ambulatory Surgical Center 8123293867 Receives reassigned benefits from 5 practitioners
Practice locations: Belleville, IL

Care Compare: Ambulatory surgical center

Medicare Care Compare
Listed as
Bel Clair Ambulatory Surgical Treatment Center LTDCCN 14C0001065
Medicare certification status
ActiveFrom the Provider of Services file

National Provider Directory

National Provider Directory
Tax ID family
Bel Clair Ambulatory Surgical Treatment Center LTD2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1162425600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1217376000000",
    "number": "1174601223",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "325 W LINCOLN ST",
            "city": "BELLEVILLE",
            "state": "IL",
            "postal_code": "622201921",
            "telephone_number": "618-235-2299",
            "fax_number": "618-235-2556"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "325 W LINCOLN ST",
            "city": "BELLEVILLE",
            "state": "IL",
            "postal_code": "622201921",
            "telephone_number": "618-235-2299",
            "fax_number": "618-235-2556"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BEL CLAIR AMBULATORY SURGICAL TREATMENT CENTER, LTD.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-02",
        "last_updated": "2008-07-30",
        "status": "A",
        "authorized_official_last_name": "HORACE",
        "authorized_official_first_name": "DAVID",
        "authorized_official_middle_name": "RUSSELL",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "618-235-2299",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": "IL",
            "license": "7001811",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "BEL CLAIR SURGICAL CENTER",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Belleville, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 30, 2008; 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.