Surgery Center at Gateway LLC

Primary specialty

Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X

Legal business name

SURGERY CENTER AT GATEWAY LLC

Practice address

5302 Gateway Ctr
Flint, MI 48507-3930

Phone

(810) 720-9111

NPI assigned

Jan 10, 2019

Last updated

Dec 6, 2023By 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

Dr. Edward P Stack, MDNPI 1801899885

Title

Ceo

Phone

(810) 720-9111

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MI

Enrollment records 1

Other NPIs with the same Medicare PAC ID 1

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

• Surgery Center at Gateway LLC

  dba Surgery Center At Gateway

  • Anesthesiology Physician
  • Flint, MI
  • NPI 1679270144

  9133455918

  Same PAC ID

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

• Surgery Center at Gateway LLC

  dba Surgery Center At Gateway

  • Anesthesiology Physician
  • Flint, MI
  • NPI 1679270144

  O20190731003850

  Same enrollment

Listed as

Surgery Center at Gateway LLCCCN 23C0001143

Medicare certification status

ActiveFrom the Provider of Services file

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.

• Edward P Stack, M.D.

  • Ophthalmology Physician
  • Flint, MI
  • NPI 1801899885
  Authorized official Same address or phone

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

{
    "created_epoch": "1547078400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1701820800000",
    "number": "1215400320",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5302 GATEWAY CTR",
            "city": "FLINT",
            "state": "MI",
            "postal_code": "485073930"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5302 GATEWAY CTR",
            "city": "FLINT",
            "state": "MI",
            "postal_code": "485073930",
            "telephone_number": "810-720-9111"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SURGERY CENTER AT GATEWAY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-01-10",
        "last_updated": "2023-12-06",
        "certification_date": "2023-12-06",
        "status": "A",
        "authorized_official_last_name": "STACK",
        "authorized_official_first_name": "EDWARD",
        "authorized_official_middle_name": "P",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "810-720-9111",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mehulkumar V Sureja, PHARMACIST
• Palak Sureja, PHARMACIST
• Suresh Anne MD PC (Asthma, Allergy and Immunology Center)
• Swarna Varshini Suresh, M.D.
• Alexandra Surgalski
• Surgery Center at Gateway LLC (Surgery Center At Gateway)
• John Michael Sushynski, D.D.S., M.S.
• Mittal Suthar, FNP-C
• Christina Sutherland
• Latia Sutton

• Ambulatory Surgical Clinic/Center in Flint, MI
• Providers in Flint, MI by specialty
• Ambulatory Surgical Clinic/Center in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 6, 2023; 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.