Phoenix Orthopaedic Ambulatory Center, LLC

Primary specialty

Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X

License

OSC3177 Issued in AZ

Legal business name

PHOENIX ORTHOPAEDIC AMBULATORY CENTER, LLC

Doing business as

Gateway Surgery Center

Practice address

690 N Cofco Center CT
Suite 150
Phoenix, AZ 85008-6462

Phone

(602) 288-4441

Fax

(602) 288-4480

NPI assigned

Aug 17, 2005

Last updated

Apr 27, 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. Jeffrey Snodgrass

Title

President

Phone

(615) 665-1283

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Gateway Surgery Center Doing business as

Medicare fee-for-service enrollment

Enrolled in AZ

Enrollment records 1

Listed as

Gateway Surgery CenterCCN 03C0001256

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

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

• Banner Health

  dba Banner Casa Grande Medical Center

  • General Acute Care Hospital
  • Casa Grande, AZ
  • NPI 1003232976

  Member Of

  NPD member

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

{
    "created_epoch": "1124236800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1619481600000",
    "number": "1336131143",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "690 N COFCO CENTER CT",
            "address_2": "SUITE 150",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850086462",
            "telephone_number": "602-288-4441",
            "fax_number": "602-288-4480"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "690 N COFCO CENTER CT",
            "address_2": "SUITE 150",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850086462",
            "telephone_number": "602-288-4441",
            "fax_number": "602-288-4480"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PHOENIX ORTHOPAEDIC AMBULATORY CENTER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-08-17",
        "last_updated": "2021-04-27",
        "certification_date": "2021-04-27",
        "status": "A",
        "authorized_official_last_name": "SNODGRASS",
        "authorized_official_first_name": "JEFFREY",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "615-665-1283",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": "AZ",
            "license": "OSC3177",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS OF ARIZONA",
            "identifier": "AZ0208190",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Gateway Surgery Center",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Gateway Surgery Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Phoenix Ophthalmologists PA
• Phoenix Ophthalmology ASC LLC (Arizona Ophthalmic Outpatient Surgery)
• Phoenix Oral and Maxillofacial Surgeons
• Phoenix Oral Surgery Associates PLLC
• Phoenix Orthodontics LLC
• Phoenix Orthopaedic Consultants, P.C.
• Phoenix Orthopaedic Surgeons, LTD
• Phoenix Orthopedic Group
• Phoenix Orthopedic Group PC
• Phoenix Outpatient Surgery Center LLC

• Ambulatory Surgical Clinic/Center in Phoenix, AZ
• Providers in Phoenix, AZ by specialty
• Ambulatory Surgical Clinic/Center in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 27, 2021; 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.