East Mequon Surgery Center LLC

Primary specialty

Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X

Legal business name

EAST MEQUON SURGERY CENTER LLC

Practice address

12203 Corporate Pkwy
Mequon, WI 53092-3388

Phone

(262) 387-8383

Fax

(262) 387-8384

NPI assigned

Sep 19, 2005

Last updated

Oct 3, 2025By 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

Kara Richardson

Title

Assistant Treasurer

Phone

(704) 631-0450

Specialties & licenses 1

Addresses

Other identifiers 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in WI

Enrollment records 1

Listed as

East Mequon Surgery Center LLCCCN 52C0001057

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.

• Aurora Health Care Ventures, Inc.

  • Eyewear Supplier
  • Plymouth, WI
  • NPI 1245251016

  Member Of

  NPD member

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

{
    "created_epoch": "1127088000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1759449600000",
    "number": "1346235058",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 909981",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532098981",
            "telephone_number": "414-352-3341",
            "fax_number": "414-247-4588"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12203 CORPORATE PKWY",
            "city": "MEQUON",
            "state": "WI",
            "postal_code": "530923388",
            "telephone_number": "262-387-8383",
            "fax_number": "262-387-8384"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EAST MEQUON SURGERY CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-09-19",
        "last_updated": "2025-10-03",
        "certification_date": "2025-10-03",
        "status": "A",
        "authorized_official_last_name": "RICHARDSON",
        "authorized_official_first_name": "KARA",
        "authorized_official_title_or_position": "ASSISTANT TREASURER",
        "authorized_official_telephone_number": "704-631-0450"
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": "WI",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "41913600",
            "state": "WI"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://esmd.abilitynetwork.com:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service",
            "affiliation": "Y",
            "endpointDescription": "2.16.840.1.113883.3.667.2",
            "affiliationName": "Ability Network",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "2.16.840.1.113883.3.667.2",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "64 S Price Rd STE B",
            "city": "Brownsville",
            "state": "TX",
            "country_code": "US",
            "postal_code": "785212459",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Danielle Dyer, DPT
• Krista M Dyreson, M.D.
• Drew David Dyrssen, LPC
• Dysphagia Testing, LLC
• Ease Chiropractic LLC
• East Town Professional Associates, S.C.
• East Towne Dental Associated Belgium Family Dental SC
• Thomas L Eaton, MD
• Halie Ecker, MS, LPC, SAC, PMH-C
• Isabella Eckert

• Ambulatory Surgical Clinic/Center in Mequon, WI
• Providers in Mequon, WI by specialty
• Ambulatory Surgical Clinic/Center in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 3, 2025; 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.