Ambulatory Surgery Center of Bala Cynwyd, LLC

Primary specialty

Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X

Legal business name

AMBULATORY SURGERY CENTER OF BALA CYNWYD, LLC

Practice address

100 Presidential Blvd FL 4
Bala Cynwyd, PA 19004-1108

Phone

(407) 960-7990

Fax

(321) 972-4252

NPI assigned

Jan 8, 2021

Last updated

Jan 8, 2021By 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. Michael Thomas Tricoli, ESQ.

Title

Counsel

Phone

(407) 947-3084

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in PA

Enrollment records 1

Locations

Practitioners 1

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.

• Scott Steven Katzman, M.D.

  • Orthopaedic Surgery Physician
  • West Orange, NJ
  • NPI 1376590646
  NPD (past)

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

{
    "created_epoch": "1610064000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1610064000000",
    "number": "1306434998",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "660 PALM SPRINGS DR STE C",
            "city": "ALTAMONTE SPRINGS",
            "state": "FL",
            "postal_code": "327017864",
            "telephone_number": "407-960-7990",
            "fax_number": "321-972-4252"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 PRESIDENTIAL BLVD FL 4",
            "city": "BALA CYNWYD",
            "state": "PA",
            "postal_code": "190041108",
            "telephone_number": "407-960-7990",
            "fax_number": "321-972-4252"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AMBULATORY SURGERY CENTER OF BALA CYNWYD, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-01-08",
        "last_updated": "2021-01-08",
        "certification_date": "2021-01-08",
        "status": "A",
        "authorized_official_last_name": "TRICOLI",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "THOMAS",
        "authorized_official_title_or_position": "COUNSEL",
        "authorized_official_telephone_number": "407-947-3084",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "ESQ."
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Ambulatory Surgical Clinic/Center in Bala Cynwyd, PA
• Providers in Bala Cynwyd, PA by specialty
• Ambulatory Surgical Clinic/Center in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 8, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.