Alderwood Surgery Center LLC

Primary specialty

Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X

Legal business name

ALDERWOOD SURGERY CENTER LLC

Practice address

600 Broadway
Suite 320
Seattle, WA 98122

Phone

(206) 324-1120

NPI assigned

Jan 14, 2008

Organization subpart

No

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

Authorized official

Name

Gricelda Prado

Title

Chief Operating Officer

Phone

(206) 209-0988

Specialties & licenses 1

Addresses

Other names 1

• Seattle Plastic Surgery Center Former legal business name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1205012887. Details of each certification follow.

• CCN 50C0001054 Ambulatory surgical center · Active · Name & address match · Details

Ambulatory surgical center certification: CCN 50C0001054

Legal name

SEATTLE PLASTIC SURGERY CENTER

Certification status

Active

Provider type (POS)

Ambulatory surgical center

Participating since

Feb 26, 1992

Last certification

Jan 11, 2017

Ownership / control type

Proprietary

Facility address

600 Broadway, Suite 320
Seattle, WA 98122

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 1

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.

• Robert Grenley

  • Plastic Surgery Physician
  • Seattle, WA
  • NPI 1124223375
  NPD (past)

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

{
    "created_epoch": "1200268800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1531872000000",
    "number": "1205012887",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "600 BROADWAY",
            "address_2": "SUITE 320",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981225395"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "600 BROADWAY",
            "address_2": "SUITE 320",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "98122",
            "telephone_number": "206-324-1120"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ALDERWOOD SURGERY CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-01-14",
        "last_updated": "2018-07-18",
        "status": "A",
        "authorized_official_last_name": "PRADO",
        "authorized_official_first_name": "GRICELDA",
        "authorized_official_title_or_position": "CHIEF OPERATING OFFICER",
        "authorized_official_telephone_number": "206-209-0988"
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Seattle Plastic Surgery Center",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Seattle Plastic Surgery Center",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Seattle Plastic Surgery Center",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

• Linda Alder
• Matthew Howe Alder, LMHCA
• Hannah Alderete, MA, LMFTA, LMHCA
• Mariah Alderete
• Sylvester Alderman
• Shawky Alsayed Aldesoky, MD
• Jessica Aldous
• Belinda Aldrich, RPH
• Felecia Z Aldrich, P.T.
• Jeffrey R Aldrich, LMP

• Ambulatory Surgical Clinic/Center in Seattle, WA
• Providers in Seattle, WA by specialty
• Ambulatory Surgical Clinic/Center in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 18, 2018; 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.