Advanced Surgical Center, LLC

Primary specialty

Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X

License

130304 Issued in TX

Legal business name

ADVANCED SURGICAL CENTER, LLC

Practice address

1018 E Wheatland Rd
Duncanville, TX 75116-4914

Phone

(972) 646-1159

NPI assigned

Feb 13, 2017

Last updated

Feb 13, 2017By 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

Amit Guttigoli, MDNPI 1760417026

Title

Managing Member

Phone

(469) 358-9380

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in TX

Enrollment records 1

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1194264036. Details of each certification follow.

• CCN 45C0001634 Ambulatory surgical center · Active · Name & address match · Details

Ambulatory surgical center certification: CCN 45C0001634

Legal name

ADVANCED SURGICAL CENTER LLC

Certification status

Active

Provider type (POS)

Ambulatory surgical center

Participating since

Nov 17, 2017

Last certification

Nov 17, 2020

Ownership / control type

Proprietary

Facility address

1018 E Wheatland Rd
Duncanville, TX 75116

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 2

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.

• Amit Guttigoli, MD

  • Cardiovascular Disease Physician
  • Duncanville, TX
  • NPI 1760417026
  NPD Authorized official
• Tim T Issac, M.D.

  • Cardiovascular Disease Physician
  • Dallas, TX
  • NPI 1013116805
  NPD (past)

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

{
    "created_epoch": "1486944000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1486944000000",
    "number": "1194264036",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1018 E WHEATLAND RD",
            "city": "DUNCANVILLE",
            "state": "TX",
            "postal_code": "751164914",
            "telephone_number": "972-646-1159"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1018 E WHEATLAND RD",
            "city": "DUNCANVILLE",
            "state": "TX",
            "postal_code": "751164914",
            "telephone_number": "972-646-1159"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ADVANCED SURGICAL CENTER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-02-13",
        "last_updated": "2017-02-13",
        "status": "A",
        "authorized_official_last_name": "GUTTIGOLI",
        "authorized_official_first_name": "AMIT",
        "authorized_official_title_or_position": "MANAGING MEMBER",
        "authorized_official_telephone_number": "469-358-9380",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": "TX",
            "license": "130304",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Ambulatory Surgical Clinic/Center in Duncanville, TX
• Providers in Duncanville, TX by specialty
• Ambulatory Surgical Clinic/Center in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 13, 2017; 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.
• 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.