Tri-State Surgery Center, L.L.C.

Primary specialty

Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X

License

261QA1903X Issued in IA

Legal business name

TRI-STATE SURGERY CENTER, L.L.C.

Practice address

1500 Associates Dr
Dubuque, IA 52002-2201

Phone

(563) 584-4536

Fax

(563) 584-4526

NPI assigned

Jul 5, 2005

Organization subpart

No

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

Authorized official

Name

Barbara Ann Perleth

Title

Business Office Manager

Phone

(563) 584-4506

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• Dubuque Regional Ambulatory Surgical Center, L.L.C. Former legal business name

Medicare fee-for-service enrollment

Enrolled in IA

Enrollment records 1

Listed as

Tri State Surgery Center LLCCCN 16C0001010

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

Practitioners 1

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

• Bruce Alan Obbink, M.D.

  • Surgery Physician
  • Dubuque, IA
  • NPI 1669424644
  NPD (past)

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

{
    "created_epoch": "1120521600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1338422400000",
    "number": "1275530271",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1500 ASSOCIATES DR",
            "city": "DUBUQUE",
            "state": "IA",
            "postal_code": "520022201",
            "telephone_number": "563-584-4536",
            "fax_number": "563-584-4526"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1500 ASSOCIATES DR",
            "city": "DUBUQUE",
            "state": "IA",
            "postal_code": "520022201",
            "telephone_number": "563-584-4536",
            "fax_number": "563-584-4526"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TRI-STATE SURGERY CENTER, L.L.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-07-05",
        "last_updated": "2012-05-31",
        "status": "A",
        "authorized_official_last_name": "PERLETH",
        "authorized_official_first_name": "BARBARA",
        "authorized_official_middle_name": "ANN",
        "authorized_official_title_or_position": "BUSINESS OFFICE MANAGER",
        "authorized_official_telephone_number": "563-584-4506"
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": "IA",
            "license": "261QA1903X",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BC/BS PROVIDER NUMBER",
            "identifier": "61010",
            "state": "IA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0610139",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Dubuque Regional Ambulatory Surgical Center, L.L.C.",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

• Shawna Lee Tobin
• Susan Lynn Tonn, MS, CCC-SLP
• Townclock Mental Health PC
• Heidi Elizabeth Townsend, MD
• Tri-State Family Practice LLP
• Tri-State Vein Center
• Tri-States Clinic of Chiropractic, P.C.
• True Health Chiropractic and Acupuncture, P.C.
• Truly Balanced, L.L.C.
• Bryan Nicholas Trumm, M.D., D.P.T.

• Ambulatory Surgical Clinic/Center in Dubuque, IA
• Providers in Dubuque, IA by specialty
• Ambulatory Surgical Clinic/Center in Iowa

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 31, 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.