NPIMap

Organization Active NPI

Renaissance Surgery Center, LLC

  • Ambulatory Surgical Clinic/Center
  • Wyckoff, NJ
National Provider Identifier
1174884530
Registry record updated Feb 15, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X
Legal business name
RENAISSANCE SURGERY CENTER, LLC
Practice address
461 Goffle Rd
Wyckoff, NJ 07481-3003
Phone
(201) 857-0720
Fax
(201) 857-0948
NPI assigned
Jun 1, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 15, 2017

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

Authorized official

Name
Mr. Louis G Quartararo, MDNPI 1467460089
Title
Managing Partner
Phone
(201) 857-0720

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)CodeLicenseStatePrimary
Ambulatory Surgical Clinic/Center 261QA1903X Primary

Addresses

Primary practice location

461 Goffle Rd
Wyckoff, NJ 07481-3003

Mailing address

461 Goffle Rd
Wyckoff, NJ 07481-3003
Phone (201) 857-0720

Other names 1

  • International Center for Minimally Invasive Spine Surgery, LLC Doing business as

National Provider Directory

National Provider Directory

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 2

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

NPI Registry JSON

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

{
    "created_epoch": "1338508800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1487116800000",
    "number": "1174884530",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "461 GOFFLE RD",
            "city": "WYCKOFF",
            "state": "NJ",
            "postal_code": "074813003",
            "telephone_number": "201-857-0720",
            "fax_number": "201-857-0948"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "461 GOFFLE RD",
            "city": "WYCKOFF",
            "state": "NJ",
            "postal_code": "074813003",
            "telephone_number": "201-857-0720",
            "fax_number": "201-857-0948"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RENAISSANCE SURGERY CENTER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-06-01",
        "last_updated": "2017-02-15",
        "status": "A",
        "authorized_official_last_name": "QUARTARARO",
        "authorized_official_first_name": "LOUIS",
        "authorized_official_middle_name": "G",
        "authorized_official_title_or_position": "MANAGING PARTNER",
        "authorized_official_telephone_number": "201-857-0720",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "International Center for Minimally Invasive Spine Surgery, LLC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Wyckoff, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 15, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.