Organization Active NPI

Surgicare LLC

  • Ambulatory Surgical Clinic/Center
  • Bloomington, IN
National Provider Identifier
1346210259
Registry record updated Dec 5, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X
Legal business name
SURGICARE LLC
Practice address
2907 McIntyre Dr
Bloomington, IN 47403-4209
Phone
(812) 339-8000
Fax
(812) 339-2524
NPI assigned
Jan 24, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 5, 2024

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

Authorized official

Name
Todd A Eads, MDNPI 1902063225
Title
Managing Member
Phone
(812) 339-8000

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ambulatory Surgical Clinic/Center 261QA1903X Primary

Addresses

Primary practice location

2907 McIntyre Dr
Bloomington, IN 47403-4209

Mailing address

2907 McIntyre Dr
Bloomington, IN 47403-4209
Phone (812) 339-8000

Other identifiers 2

IdentifierTypeStateIssuer
000000098138OtherINANTHEM BLUE SHIELD
ZB0750OtherINTRAVELERS MEDICARE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20080523000295 IN Part B Supplier - Ambulatory Surgical Center 3375612849 Practice locations: Bloomington, IN

Care Compare: Ambulatory surgical center

Medicare Care Compare
Listed as
Surgicare LLCCCN 15C0001069
Medicare certification status
ActiveFrom the Provider of Services file

National Provider Directory

National Provider Directory

Member of 1

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

Locations

2907 S McIntire Dr
Ste C
Bloomington, IN 47403
Phone (812) 339-8000

Practitioners & affiliated clinicians

Practitioners 2

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

NPI Registry JSON

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

{
    "created_epoch": "1138060800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1733356800000",
    "number": "1346210259",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2907 MCINTYRE DR",
            "city": "BLOOMINGTON",
            "state": "IN",
            "postal_code": "474034209",
            "telephone_number": "812-339-8000",
            "fax_number": "812-339-2524"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2907 MCINTYRE DR",
            "city": "BLOOMINGTON",
            "state": "IN",
            "postal_code": "474034209",
            "telephone_number": "812-339-8000",
            "fax_number": "812-339-2524"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SURGICARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-01-24",
        "last_updated": "2024-12-05",
        "certification_date": "2024-12-05",
        "status": "A",
        "authorized_official_last_name": "EADS",
        "authorized_official_first_name": "TODD",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "MANAGING MEMBER",
        "authorized_official_telephone_number": "812-339-8000",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM BLUE SHIELD",
            "identifier": "000000098138",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TRAVELERS MEDICARE",
            "identifier": "ZB0750",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bloomington, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 5, 2024; 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.