NPIMap

Organization Active NPI

Mission Surgery Center LLC

  • Ambulatory Surgical Clinic/Center
  • San Antonio, TX
National Provider Identifier
1194323725
Registry record updated Oct 15, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X
Legal business name
MISSION SURGERY CENTER LLC
Practice address
603 E Amber St, Suite 103
San Antonio, TX 78221-7822
Phone
(210) 259-5836
NPI assigned
Oct 15, 2020
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 15, 2020

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

Authorized official

Name
Carl Negley
Title
Administrator
Phone
(210) 259-5836

Specialties & licenses 1

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

Addresses

Primary practice location

603 E Amber St, Suite 103
San Antonio, TX 78221-7822

Mailing address

708 Canterbury Hill St
San Antonio, TX 78209-2820
Phone (210) 259-5836

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20210315000961 TX Part B Supplier - Ambulatory Surgical Center 4082020292 Practice locations: San Antonio, TX

Ambulatory surgical center certification: CCN 45C0451256

Name & address match This certification has no NPI in the Medicare enrollment files. CMS publishes enrollment files for six facility types only, so it was connected to this NPI by matching the name and address CMS publishes for it.

Legal name
Mission Surgery Center
Certification status
Active
Provider type (POS)
Ambulatory surgical center
Participating since
Apr 7, 2023
Last certification
Apr 7, 2023
Ownership / control type
Proprietary
Facility address
603 E Amber Street Suite 103
San Antonio, TX 78221

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
45D2238850Mission Surgery Center, LLC603 E Amber Street, Suite 103, San Antonio, TX 78221Certificate of waiverOct 5, 2027

National Provider Directory

National Provider Directory

Locations

603 E Amber St
Ste 103
San Antonio, TX 78221
Phone (210) 259-5836

Practitioners & affiliated clinicians

Practitioners 9

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": "1602720000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1602720000000",
    "number": "1194323725",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "708 CANTERBURY HILL ST",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782092820",
            "telephone_number": "210-259-5836"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "603 E AMBER ST, SUITE 103",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782217822",
            "telephone_number": "210-259-5836"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MISSION SURGERY CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-10-15",
        "last_updated": "2020-10-15",
        "certification_date": "2020-10-13",
        "status": "A",
        "authorized_official_last_name": "NEGLEY",
        "authorized_official_first_name": "CARL",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "210-259-5836"
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Antonio, TX

Sources for this page

Verify at the official NPI Registry.