Atlantic SC LLC – Ambulatory Surgical Clinic/Center

Key facts

NPI: 1295494359
Entity type: Organization (NPI type 2)
Primary specialty: Ambulatory Surgical Clinic/Center 261QA1903X
Legal business name: ATLANTIC SC LLC
Practice address: 1145 Montauk Hwy
West Islip, NY 11795-4909
Phone: (631) 743-1145
NPI assigned: Dec 15, 2021
Organization subpart: No

Authorized official

Name: Marianne Jorgensen
Title: Office Administrator
Phone: (631) 743-1145

Practitioners 1

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

Nitin Rajkumar Mariwalla, MD, MPH, MS Neurological Surgery Physician · West Islip, NY · NPI 1033378161

NPD (past)

Medicare Care Compare: Ambulatory surgical center

Listed as: Atlantic SC LLC CCN 33C0001205
Medicare certification status: Active (Provider of Services file)

Source: Medicare Care Compare.

Laboratory certificates & supplier records

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

CLIA laboratory certificates

CLIA number	Laboratory	Certificate	Expires
33D2245377	Atlantic SC LLC 1145 Montauk Hwy, West Islip, NY 11795	Certificate of waiver	Mar 26, 2027

Medicare participation

Medicare fee-for-service enrollment: Enrolled in NY

Medicare enrollment records

Enrollment ID	State	Provider type	PAC ID	Details
O20220614000999	NY	Part B Supplier - Ambulatory Surgical Center	1658750195	Practice locations: West Islip, NY

National Provider Directory

Specialties & licenses

Specialty (taxonomy)	Code	License	State	Primary
Clinic/Center	261Q00000X
Ambulatory Surgical Clinic/Center	261QA1903X			Yes

Addresses

Primary practice location

1145 Montauk Hwy
West Islip, NY 11795-4909

Mailing address

1145 Montauk Hwy
West Islip, NY 11795-4909
Phone (631) 743-1145

Other providers in West Islip, NY

Wilbur Jeremiah Asheld, DO
Ashley Brethel Speech-Language Pathology PLLC
Annabelle Jolicoeur Assad, MD
Athanasios Antoniadis OB GYN PC
Atlantic Neurosurgery PC
Uschi Chantal Auguste, MD
Paxton Pyee Kyaw Aung, DO
Rosheen Awais, DPM
Taner A Aydin, MD
Yonael Ayinalem, MD

All providers in West Islip, NY · Ambulatory Surgical Clinic/Center in New York

Sources for this page

NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 19, 2022. Information in NPPES is self-reported and not verified by CMS.
NUCC Health Care Provider Taxonomy: specialty names.
Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
Medicare Care Compare provider data (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.