NPIMap

Organization Active NPI

Surgicare, LLC

  • Ambulatory Surgical Clinic/Center
  • Phoenix, AZ
National Provider Identifier
1235100314
Registry record updated Mar 20, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X
License
OSC 0051 Issued in AZ
Legal business name
SURGICARE, LLC
Practice address
5115 N Central Ave
Phoenix, AZ 85012-1478
Phone
(602) 264-1818
Fax
(602) 264-2172
NPI assigned
Jan 27, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 20, 2008

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

Authorized official

Name
Dr. Ellison F Herro, MDNPI 1437149473
Title
Owner/Medical Director
Phone
(602) 264-1395

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 OSC 0051 AZ Primary

Addresses

Primary practice location

5115 N Central Ave
Phoenix, AZ 85012-1478

Mailing address

5133 N Central Ave
Suite 200
Phoenix, AZ 85012-1438
Phone (602) 264-1395

Other identifiers 2

IdentifierTypeStateIssuer
062810MedicaidAZ
AZ0201540OtherAZBLUECROSS BLUESHIELD AZ

National Provider Directory

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": "1138320000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1205971200000",
    "number": "1235100314",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5133 N CENTRAL AVE",
            "address_2": "SUITE 200",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850121438",
            "telephone_number": "602-264-1395",
            "fax_number": "602-264-2172"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5115 N CENTRAL AVE",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850121478",
            "telephone_number": "602-264-1818",
            "fax_number": "602-264-2172"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SURGICARE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-01-27",
        "last_updated": "2008-03-20",
        "status": "A",
        "authorized_official_last_name": "HERRO",
        "authorized_official_first_name": "ELLISON",
        "authorized_official_middle_name": "F",
        "authorized_official_title_or_position": "OWNER/MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "602-264-1395",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": "AZ",
            "license": "OSC 0051",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "062810",
            "state": "AZ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUECROSS BLUESHIELD AZ",
            "identifier": "AZ0201540",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Phoenix, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 20, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.