Granger Surgery Center LLC
Organization Active NPI Ambulatory Surgical Clinic/Center · Granger, IN
NPI 1215675111 · NPPES record last updated Feb 12, 2026
Key facts
- NPI
- 1215675111
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Ambulatory Surgical Clinic/Center 261QA1903X
- Legal business name
- GRANGER SURGERY CENTER LLC
- Practice address
- 51050 Bittersweet Rd Ste a
Granger, IN 46530-7879 - Phone
- (718) 208-0446
- Fax
- (574) 244-0240
- NPI assigned
- May 22, 2022
- Organization subpart
- No
Authorized official
- Name
- Kristina Music, AUTHORIZED OFFICIAL
- Title
- Director of Provider Enrollment
- Phone
- (615) 465-7377
Member of 1
Practitioners 2
-
Roni Aizigov, CRNA, NP-C
Medicare Care Compare: Ambulatory surgical center
- Listed as
- Granger Surgery Center LLC
- Medicare certification status
- Active
Laboratory certificates & supplier records
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 15D2264013 | Granger Surgery Center | Certificate of waiver | Jul 7, 2028 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in IN
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20221012001511 | IN | Part B Supplier - Ambulatory Surgical Center | 8820464183 | Practice locations: Granger, IN |
National Provider Directory
Locations
51050 Bittersweet Rd
Ste A
Granger, IN 46530
Phone (574) 208-1612
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Ambulatory Surgical Clinic/Center | 261QA1903X | Yes |
Addresses
Primary practice location
51050 Bittersweet Rd Ste a
Granger, IN 46530-7879
Mailing address
51050 Bittersweet Rd Ste a
Granger, IN 46530-7879
Phone (574) 228-5440
Other names
- Granger Surgery Center
- Northern Indiana Surgery Center LLC
Other providers in Granger, IN
- Darren Robert Goodwin
- Granger Counseling
- Granger Dental Group, LLC
- Granger Family Dentistry, PC
- Granger Family Eyecare Inc
- Granger Village Doctor PC
- Great Lakes Behavior Management Specialists, Inc.
- Greater Michiana Family Services, Inc.
- Katherine Mavis Greene
- Jamie Greenway
All providers in Granger, IN · Ambulatory Surgical Clinic/Center in Indiana
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 12, 2026. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.