Elite Surgical Center LLC

Primary specialty

Clinic/CenterTaxonomy code 261Q00000X

Legal business name

ELITE SURGICAL CENTER LLC

Practice address

307 Hamburg Turnpike
Wayne, NJ 07470

Phone

(973) 790-7700

NPI assigned

Aug 19, 2006

Last updated

Oct 9, 2012By 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

Mr. Dennis William Simmons

Title

Coo

Phone

(973) 709-1900

Specialties & licenses 1

Addresses

Other names 1

• Wayne Surgical Center LLC Former legal business name

Medicare fee-for-service enrollment

Enrolled in NJ2 enrollments

Enrollment records 2

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

• Wayne Surgical Center LLC

  • Ambulatory Surgical Clinic/Center
  • Wayne, NJ
  • NPI 1184749673

  O20081107000514

  Same enrollment

Listed as

Elite Surgical Center LLCCCN 31C0001206

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

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Fereydoon Ghobadi, M.D.

  • Orthopaedic Hand Surgery Physician
  • Wayne, NJ
  • NPI 1912952607
  NPD (past)
• Marc Kitrosser, DPM

  • Foot & Ankle Surgery Podiatrist
  • Woodland Park, NJ
  • NPI 1922035575
  NPD (past)

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

{
    "created_epoch": "1155945600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1349740800000",
    "number": "1265546691",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "307 HAMBURG TURNPIKE",
            "city": "WAYNE",
            "state": "NJ",
            "postal_code": "07470",
            "telephone_number": "973-790-7700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "307 HAMBURG TURNPIKE",
            "city": "WAYNE",
            "state": "NJ",
            "postal_code": "07470",
            "telephone_number": "973-790-7700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ELITE SURGICAL CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-19",
        "last_updated": "2012-10-09",
        "status": "A",
        "authorized_official_last_name": "SIMMONS",
        "authorized_official_first_name": "DENNIS",
        "authorized_official_middle_name": "WILLIAM",
        "authorized_official_title_or_position": "COO",
        "authorized_official_telephone_number": "973-709-1900",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Wayne Surgical Center LLC",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

• Elite Oral & Maxillofacial Surgery
• Elite Orthodontics
• Elite Orthopedics and Sports Medicine, P.a.
• Elite Pulmonary and Sleep Medicine PA
• Elite RX LLC (Elite RX Solutions)
• Elizabeth Ellen DMD
• Elizabeth K Ellen, DMD
• Ashley Ellias, M.ED
• Amal Elrafei, M.ED, LAC
• Mohamed A Elrafei, MD

• Clinic/Center in Wayne, NJ
• Providers in Wayne, NJ by specialty
• Clinic/Center in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 9, 2012; 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.