Suffolk Surgery Center LLC

Primary specialty

Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X

License

5151207R Issued in NY

Legal business name

SUFFOLK SURGERY CENTER LLC

Practice address

1500 William Floyd Pkwy
Shirley, NY 11967-1800

Phone

(631) 205-9090

NPI assigned

Sep 16, 2006

Organization subpart

No

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

Authorized official

Name

Charles A Walters, RN, BA

Title

Administrator

Phone

(631) 205-9090

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in NY

Enrollment records 1

Listed as

Suffolk Surgery Center LLCCCN 33C0001053

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.

• Sight Medical Doctors PLLC

  • Ophthalmology Physician
  • Hauppauge, NY
  • NPI 1487077483

  Member Of

  NPD member

Locations

Practitioners 1

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

• Dhiren Chhotalal Mehta, MD

  • Gastroenterology Physician
  • East Moriches, NY
  • NPI 1912093444
  NPD (past)

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

{
    "created_epoch": "1158364800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1371600000000",
    "number": "1265538151",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1500 WILLIAM FLOYD PKWY",
            "city": "SHIRLEY",
            "state": "NY",
            "postal_code": "119671800",
            "telephone_number": "631-205-9090"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1500 WILLIAM FLOYD PKWY",
            "city": "SHIRLEY",
            "state": "NY",
            "postal_code": "119671800",
            "telephone_number": "631-205-9090"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUFFOLK SURGERY CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-16",
        "last_updated": "2013-06-19",
        "status": "A",
        "authorized_official_last_name": "WALTERS",
        "authorized_official_first_name": "CHARLES",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "631-205-9090",
        "authorized_official_credential": "RN, BA"
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": "NY",
            "license": "5151207R",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02553208",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Stop & Shop Supermarket Company LLC
• Kolton Stow, PT
• Suffolk Chiropractic Rehabilitation & Physical Therapy PLLC
• Suffolk Chiropractic Rehabilitation, P.C.
• Suffolk Home Care LLC
• Ramsha Suhail, MHC
• Krystal Sukhdeo, PA
• Sun River Health Inc
• Annmarie Sweeney, CASAC
• Taylor Sweezy, PHARMD

• Ambulatory Surgical Clinic/Center in Shirley, NY
• Providers in Shirley, 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 19, 2013; 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.