Executive Woods Ambulatory Surgery Center LLC

Primary specialty

Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X

License

0101219R Issued in NY

Legal business name

EXECUTIVE WOODS AMBULATORY SURGERY CENTER LLC

Practice address

3 Atrium Dr
Suite 150
Albany, NY 12205-1417

Phone

(518) 453-2361

Fax

(518) 453-1594

NPI assigned

Apr 10, 2006

Organization subpart

No

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

Authorized official

Name

Kyle R. Flik, MDNPI 1730156910

Title

Medical Director

Phone

(518) 453-2361

Specialties & licenses 1

Addresses

Other identifiers 5

Medicare fee-for-service enrollment

Enrolled in NY

Enrollment records 1

Listed as

Executive Woods Ambulatory Surgery Center LLCCCN 33C0001054

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

Member of 1

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

• Orthopedicsny, LLP

  • Orthopaedic Surgery Physician
  • Mechanicville, NY
  • NPI 1740723287

  Member Of

  NPD member

Locations

Practitioners 2

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

• Kyle Flik, MD

  • Sports Medicine (Orthopaedic Surgery) Physician
  • Albany, NY
  • NPI 1730156910
  NPD Authorized official
• Leonard E Goldstock, M.D.

  • Orthopaedic Surgery Physician
  • Albany, NY
  • NPI 1073580494
  NPD (past)

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

{
    "created_epoch": "1144627200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1753228800000",
    "number": "1265495451",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3 ATRIUM DR",
            "address_2": "SUITE 150",
            "city": "ALBANY",
            "state": "NY",
            "postal_code": "122051417",
            "telephone_number": "518-453-2361",
            "fax_number": "518-453-1594"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3 ATRIUM DR",
            "address_2": "SUITE 150",
            "city": "ALBANY",
            "state": "NY",
            "postal_code": "122051417",
            "telephone_number": "518-453-2361",
            "fax_number": "518-453-1594"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EXECUTIVE WOODS AMBULATORY SURGERY CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-04-10",
        "last_updated": "2025-07-23",
        "certification_date": "2025-07-23",
        "status": "A",
        "authorized_official_last_name": "FLIK",
        "authorized_official_first_name": "KYLE",
        "authorized_official_middle_name": "R.",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "518-453-2361",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": "NY",
            "license": "0101219R",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BSNENY  PROVIDER NUMBER",
            "identifier": "000401075000",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CDPHP PROVIDER NUMBER",
            "identifier": "10043997",
            "state": "NY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02107211",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "EMPIRE BC PROVIDER NUMBER",
            "identifier": "014594",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MVP PROVIDER NUMBER",
            "identifier": "1488",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Janeen Yvette Everhardt-Thompson
• Thomas Evers
• Michael Eversman, LCSWR
• Judith Sansone Ewing
• Excel Dental Care, P.C.
• Executive Woods Sleep Disorder Ctr LLC
• Ez Psychiatry, PLLC
• Elizabeth Ef Fabian
• Kathryn Ann Fabian, CRNA
• Andrew John Fabozzi, LMSW

• All providers in Albany, NY
• Ambulatory Surgical Clinic/Center in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 23, 2025; 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.