Center Health Surgery Center LLC

Primary specialty

Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X

Legal business name

CENTER HEALTH SURGERY CENTER LLC

Doing business as

Detroit Children's Surgery Center

Practice address

30671 Stephenson Hwy Ste F
Madison Heights, MI 48071-1635

Phone

(313) 544-3614

NPI assigned

Oct 2, 2019

Last updated

May 14, 2024By 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

Devin Larsen

Title

Ceo

Phone

(208) 340-1840

Specialties & licenses 1

Addresses

Other names 1

• Detroit Children's Surgery Center Doing business as

Medicare fee-for-service enrollment

Enrolled in MI

Enrollment records 1

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1255972113. Details of each certification follow.

• CCN 23C0001164 Ambulatory surgical center · Active · Name & address match · Details

Ambulatory surgical center certification: CCN 23C0001164

Legal name

Detroit Children's Surgery Center

Certification status

Active

Provider type (POS)

Ambulatory surgical center

Participating since

Nov 25, 2024

Last certification

Oct 22, 2024

Ownership / control type

Proprietary

Facility address

30671 Stephenson Hwy, Suite F
Madison Heights, MI 48071

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

CLIA laboratory certificates

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

{
    "created_epoch": "1569974400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1715644800000",
    "number": "1255972113",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "30671 STEPHENSON HWY STE F",
            "city": "MADISON HEIGHTS",
            "state": "MI",
            "postal_code": "480711635",
            "telephone_number": "313-544-3614"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "30671 STEPHENSON HWY STE F",
            "city": "MADISON HEIGHTS",
            "state": "MI",
            "postal_code": "480711635",
            "telephone_number": "313-544-3614"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CENTER HEALTH SURGERY CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-10-02",
        "last_updated": "2024-05-14",
        "certification_date": "2024-05-14",
        "status": "A",
        "authorized_official_last_name": "LARSEN",
        "authorized_official_first_name": "DEVIN",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "208-340-1840"
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Detroit Children's Surgery Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Ambulatory Surgical Clinic/Center in Madison Heights, MI
• Providers in Madison Heights, 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 May 14, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
• 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.