Organization Active NPI

Northeast Surgi-Care, LLC

  • Ambulatory Surgical Clinic/Center
  • Lakewood, NJ
National Provider Identifier
1194553248
Registry record updated Jul 22, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X
Legal business name
NORTHEAST SURGI-CARE, LLC
Practice address
475 Route 70 Ste 202
Lakewood, NJ 08701-5897
Phone
(732) 730-3939
Fax
(732) 730-9119
NPI assigned
Jul 22, 2024
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 22, 2024

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

Authorized official

Name
Dimitrios Lambrou, DCNPI 1184684482
Title
Member
Phone
(732) 714-0070

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

475 Route 70 Ste 202
Lakewood, NJ 08701-5897

Mailing address

475 Route 70 Ste 202
Lakewood, NJ 08701-5897
Phone (732) 730-3939

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20250606002607 NJ Part B Supplier - Ambulatory Surgical Center 2567738461 Practice locations: Lakewood, NJ

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

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
31D2027255Northeast Surgi-Care, LLC475 Route 70, Lakewood, NJ 08701Certificate of waiverJul 19, 2027

National Provider Directory

National Provider Directory
Tax ID family
Northeast Surgi-Care LLC2 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 1

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": "1721606400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1721606400000",
    "number": "1194553248",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "475 ROUTE 70 STE 202",
            "city": "LAKEWOOD",
            "state": "NJ",
            "postal_code": "087015897",
            "telephone_number": "732-730-3939",
            "fax_number": "732-730-9119"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "475 ROUTE 70 STE 202",
            "city": "LAKEWOOD",
            "state": "NJ",
            "postal_code": "087015897",
            "telephone_number": "732-730-3939",
            "fax_number": "732-730-9119"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTHEAST SURGI-CARE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-07-22",
        "last_updated": "2024-07-22",
        "certification_date": "2024-07-22",
        "status": "A",
        "authorized_official_last_name": "LAMBROU",
        "authorized_official_first_name": "DIMITRIOS",
        "authorized_official_title_or_position": "MEMBER",
        "authorized_official_telephone_number": "732-714-0070",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lakewood, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 22, 2024; 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.