Active NPI
Minimally Invasive Surgery Center of N.E., LLC
- Ambulatory Surgical Clinic/Center
- Bedford, NH
National Provider Identifier
1205361052
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Ambulatory Surgical Clinic/Center
- Legal business name
- MINIMALLY INVASIVE SURGERY CENTER OF N.E., LLC
- Practice address
- 4 Hawthorne Dr
Bedford, NH 03110-6983 - Phone
- (603) 218-1912
- Fax
- (603) 218-1914
- NPI assigned
- Apr 28, 2017
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Jonathan Bailey
- Title
- Officer/Authorized Official
- Phone
- (203) 609-1168
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Ambulatory Surgical Clinic/Center | 261QA1903X | Primary | ||
| Multi-Specialty Clinic/Center | 261QM1300X |
Addresses
Primary practice location
4 Hawthorne Dr
Bedford, NH 03110-6983
Mailing address
4 Hawthorne Dr
Bedford, NH 03110-6983
Phone (603) 472-8888
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| CONNECT URL | https://esmd.abilitynetwork.com:8291/gateway/documentsubmission/2_0/NhinService/XDRRequest_Service | Other | Ability Network |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NH
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20171011000347 | NH | Part B Supplier - Ambulatory Surgical Center | 4789959131 | Practice locations: Bedford, NH |
Care Compare: Ambulatory surgical center
Medicare Care Compare- Listed as
- Minimally Invasive Surgery Center of New England
- Medicare certification status
- Active
Care Compare: Ambulatory surgical center
Medicare Care Compare- Listed as
- Minimally Invasive Surgery Center of New England
- Medicare certification status
- Active
National Provider Directory
National Provider DirectoryMember of 2
Organizations this organization is a member of, according to 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.
-
- Neurological Surgery Physician
- Bedford, NH
- NPI 1366694895
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1493337600000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1725494400000",
"number": "1205361052",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4 HAWTHORNE DR",
"city": "BEDFORD",
"state": "NH",
"postal_code": "031106983",
"telephone_number": "603-472-8888",
"fax_number": "603-472-9090"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4 HAWTHORNE DR",
"city": "BEDFORD",
"state": "NH",
"postal_code": "031106983",
"telephone_number": "603-218-1912",
"fax_number": "603-218-1914"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "MINIMALLY INVASIVE SURGERY CENTER OF N.E., LLC",
"organizational_subpart": "NO",
"enumeration_date": "2017-04-28",
"last_updated": "2024-09-05",
"certification_date": "2024-09-05",
"status": "A",
"authorized_official_last_name": "BAILEY",
"authorized_official_first_name": "JONATHAN",
"authorized_official_title_or_position": "OFFICER/AUTHORIZED OFFICIAL",
"authorized_official_telephone_number": "203-609-1168"
},
"taxonomies": [
{
"code": "261QA1903X",
"taxonomy_group": "",
"desc": "Clinic/Center, Ambulatory Surgical",
"state": null,
"license": null,
"primary": true
},
{
"code": "261QM1300X",
"taxonomy_group": "",
"desc": "Clinic/Center, Multi-Specialty",
"state": null,
"license": null,
"primary": false
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "CONNECT",
"endpointTypeDescription": "CONNECT URL",
"endpoint": "https://esmd.abilitynetwork.com:8291/gateway/documentsubmission/2_0/NhinService/XDRRequest_Service",
"affiliation": "Y",
"endpointDescription": "2.16.840.1.113883.3.667.2",
"affiliationName": "Ability Network",
"use": "OTHER",
"useDescription": "Other",
"useOtherDescription": "CMS esMD eMDR",
"address_1": "100 N 6th St Ste 900A",
"city": "Minneapolis",
"state": "MN",
"country_code": "US",
"postal_code": "554031516",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}
Other providers in Bedford, NH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 5, 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.