Great Lakes Surgical Center, LLC

Primary specialty

Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X

License

1010000049 Issued in MI

Legal business name

GREAT LAKES SURGICAL CENTER, LLC

Practice address

26051 Lahser Rd
Southfield, MI 48033-2601

Phone

(248) 223-9925

NPI assigned

Feb 12, 2014

Organization subpart

No

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

Authorized official

Name

Keith Metz, MD

Title

Medical Director

Phone

(248) 223-9925

Specialties & licenses 1

Addresses

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

CLIA laboratory certificates

Tax ID family

Great Lakes Surgical Center2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Great Lakes Surgical Center LLC

  • Ambulatory Surgical Clinic/Center
  • Southfield, MI
  • NPI 1568420388
  NPD tax ID

Practitioners 1

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

• Richard Eun Han, MD

  • Anesthesiology Physician
  • Ann Arbor, MI
  • NPI 1255452918
  NPD

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

{
    "created_epoch": "1392163200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1392163200000",
    "number": "1265856231",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "26051 LAHSER RD",
            "city": "SOUTHFIELD",
            "state": "MI",
            "postal_code": "480332601",
            "telephone_number": "248-223-9925"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "26051 LAHSER RD",
            "city": "SOUTHFIELD",
            "state": "MI",
            "postal_code": "480332601",
            "telephone_number": "248-223-9925"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GREAT LAKES SURGICAL CENTER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-02-12",
        "last_updated": "2014-02-12",
        "status": "A",
        "authorized_official_last_name": "METZ",
        "authorized_official_first_name": "KEITH",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "248-223-9925",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": "MI",
            "license": "1010000049",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Great Lakes Pain and Injury Center
• Great Lakes Physicians of Southfield,PLLC
• Great Lakes Research Institute LLC
• Great Lakes Surgical Center Anesthesia, PLC
• Great Lakes Surgical Center LLC
• Greater Detroit Culinary Services
• Greater Detroit Transportation
• Greater Health Center PLC
• Greater Health Center PLC
• Greater Health Services LLC

• Ambulatory Surgical Clinic/Center in Southfield, MI
• Providers in Southfield, 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 Feb 12, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• 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.