Fifth Avenue Surgery Center, LLC

Primary specialty

Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X

License

7002195R Issued in NY

Legal business name

FIFTH AVENUE SURGERY CENTER, LLC

Practice address

1049 5TH Ave
New York, NY 10028-0115

Phone

(212) 772-6667

Fax

(212) 988-8018

NPI assigned

Sep 28, 2006

Organization subpart

No

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

Authorized official

Name

Mr. Charles J Raab

Title

Chief Financial Officer

Phone

(212) 772-6667

Specialties & licenses 1

Addresses

Other identifiers 5

Other names 1

• French American Surgery Center Former legal business name

Medicare fee-for-service enrollment

Enrolled in NY2 enrollments

Enrollment records 2

Listed as

Fifth Ave Surgery Center LLCCCN 33C0001022

Medicare certification status

ActiveFrom the Provider of Services file

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Stanislav Lando, CRNA, MSN, APP

  • Certified Registered Nurse Anesthetist
  • Newark, NJ
  • NPI 1780985309
  NPD

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

{
    "created_epoch": "1159401600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1307059200000",
    "number": "1235220682",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1049 5TH AVE",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100280115",
            "telephone_number": "212-772-6667",
            "fax_number": "212-988-8018"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1049 5TH AVE",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100280115",
            "telephone_number": "212-772-6667",
            "fax_number": "212-988-8018"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FIFTH AVENUE SURGERY CENTER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-28",
        "last_updated": "2011-06-03",
        "status": "A",
        "authorized_official_last_name": "RAAB",
        "authorized_official_first_name": "CHARLES",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "CHIEF FINANCIAL OFFICER",
        "authorized_official_telephone_number": "212-772-6667",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": "NY",
            "license": "7002195R",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01238288",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OXFORD HEALTH PLANS",
            "identifier": "ANC282",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA HEALTHCARE",
            "identifier": "0455952",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTH NET",
            "identifier": "NZ0867",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "EMPIRE BLUE CROSS",
            "identifier": "003617",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "French American Surgery Center",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

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• Ambulatory Surgical Clinic/Center in New York, NY
• Providers in New York, NY by specialty
• Ambulatory Surgical Clinic/Center in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 3, 2011; 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.