Surgery Center of Gilbert LLC

Primary specialty

Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X

License

OSC3133 Issued in AZ

Legal business name

SURGERY CENTER OF GILBERT LLC

Practice address

6003 E Baseline Rd
Mesa, AZ 85206-4815

Phone

(480) 641-6500

Fax

(480) 641-6550

NPI assigned

Jul 18, 2005

Organization subpart

No

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

Authorized official

Name

Karen M Kelly

Title

Administrator

Phone

(480) 641-6565

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• Surgery Center of Gilbert Other name

Medicare fee-for-service enrollment

Enrolled in AZ

Enrollment records 1

Listed as

Surgery Center of GilbertCCN 03C0001253

Medicare certification status

ActiveFrom the Provider of Services file

Member of 2

Organizations this organization is a member of, according to the National Provider Directory.

• Banner Health

  • Critical Access Hospital
  • Payson, AZ
  • NPI 1063923340

  Member Of

  NPD member
• VHS San Antonio Partners LLC

  • Psychiatric Hospital Unit
  • San Antonio, TX
  • NPI 1487633509

  Member Of

  NPD member

Practitioners 1

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

• Lisa Ann Mansueto, M.D.

  • Ophthalmic Plastic and Reconstructive Surgery Physician
  • Tempe, AZ
  • NPI 1396742797
  NPD (past)

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

{
    "created_epoch": "1121644800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1439337600000",
    "number": "1245239656",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6003 E BASELINE RD",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852064815",
            "telephone_number": "480-641-6500",
            "fax_number": "480-641-6550"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6003 E BASELINE RD",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852064815",
            "telephone_number": "480-641-6500",
            "fax_number": "480-641-6550"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SURGERY CENTER OF GILBERT LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-07-18",
        "last_updated": "2015-08-12",
        "status": "A",
        "authorized_official_last_name": "KELLY",
        "authorized_official_first_name": "KAREN",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "480-641-6565"
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": "AZ",
            "license": "OSC3133",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "735722",
            "state": "AZ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "490005586",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Surgery Center of Gilbert",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Supreme Positive Innovation Services LLC
• Mysore S Suresh, D.D.S
• Pooja Suresh, D.D.S.
• Surestep
• Surgery Center of Arizona LLC
• Surgery Center of Mesa LLC
• Surgical Physicians Assistants Inc
• Surgical Professionals, Inc
• Surgicare Sheridan Surgical Services
• Yolaine Suri Chavez

• Ambulatory Surgical Clinic/Center in Mesa, AZ
• Providers in Mesa, AZ by specialty
• Ambulatory Surgical Clinic/Center in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 12, 2015; 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.