Intrepid Lane ASC, LLC

Primary specialty

Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X

Legal business name

INTREPID LANE ASC, LLC

Doing business as

Intrepid Lane Ambulatory Surgery Center

Practice address

190 Intrepid LN
Syracuse, NY 13205-2545

Phone

(315) 870-9370

NPI assigned

Feb 10, 2022

Last updated

Jan 7, 2026By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Elan Salzhauer, MDNPI 1518915040

Title

Cmo

Phone

(315) 870-9370

Specialties & licenses 1

Addresses

Other names 1

• Intrepid Lane Ambulatory Surgery Center Doing business as

Medicare fee-for-service enrollment

Enrolled in NY

Enrollment records 1

Listed as

Intrepid Lane ASC LLC Dba Intrepid Lane Endoscopy and Surgery CenterCCN 33C0001210

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

Locations

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.

• Elan W Salzhauer, M.D.

  • Urology Physician
  • Liverpool, NY
  • NPI 1518915040
  NPD Authorized official
• Ilija Aleksic, M.D.

  • Urology Physician
  • Syracuse, NY
  • NPI 1962820977
  NPD
• Benjamin Robert McHone, M.D.

  • Urology Physician
  • Camillus, NY
  • NPI 1437188232
  NPD
• Elizabeth M Smith, NP

  • Nurse Practitioner
  • Fishers, IN
  • NPI 1184420416
  NPD
• Michael A Moffa, MD

  • Colon & Rectal Surgery Physician
  • East Syracuse, NY
  • NPI 1225147002
  NPD (past)

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

{
    "created_epoch": "1644451200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1767744000000",
    "number": "1184378846",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 METROPOLITAN PARK DR STE 100",
            "city": "LIVERPOOL",
            "state": "NY",
            "postal_code": "130885842",
            "telephone_number": "315-870-9370",
            "fax_number": "315-870-9364"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "190 INTREPID LN",
            "city": "SYRACUSE",
            "state": "NY",
            "postal_code": "132052545",
            "telephone_number": "315-870-9370"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INTREPID LANE ASC, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-02-10",
        "last_updated": "2026-01-07",
        "certification_date": "2026-01-07",
        "status": "A",
        "authorized_official_last_name": "SALZHAUER",
        "authorized_official_first_name": "ELAN",
        "authorized_official_title_or_position": "CMO",
        "authorized_official_telephone_number": "315-870-9370",
        "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": "Intrepid Lane Ambulatory Surgery Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Internist Associates of Central New York PC
• Internist Associates of Central New York PC
• Internist Associates of Central New York, PC
• Intouch Counseling LCSW
• Intrepid Lane Anesthesia Group PLLC
• Edward Ioffe, MD
• Michael B Iorga, MD
• Miron A Iosilevich, MD
• Lauren Ambrose Ippoliti, LCSW-R
• Mahwish Iqbal, MD

• Ambulatory Surgical Clinic/Center in Syracuse, NY
• Providers in Syracuse, NY by specialty
• Ambulatory Surgical Clinic/Center in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 7, 2026; 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.