NPIMap

Organization Active NPI

Akdhc Surgery Center, LLC

  • Ambulatory Surgical Clinic/Center
  • Phoenix, AZ
National Provider Identifier
1346469731
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X
Legal business name
AKDHC SURGERY CENTER, LLC
Practice address
3333 E Camelback Rd Ste 180
Phoenix, AZ 85018-2396
Phone
(602) 997-1098
Fax
(602) 943-1453
NPI assigned
Apr 24, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Authorized official

Name
Ms. Adonis Escobedo
Title
Credentialing Manager
Phone
(602) 759-6883

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nephrology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207RN0300X AZ
Ambulatory Surgical Clinic/Center 261QA1903X Primary

Addresses

Primary practice location

3333 E Camelback Rd Ste 180
Phoenix, AZ 85018-2396

Mailing address

3333 E Camelback Rd
Suite 180
Phoenix, AZ 85018-2322
Phone (602) 997-0484

Other identifiers 1

IdentifierTypeStateIssuer
537574MedicaidAZ

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040713001206 AZ Part B Supplier - Ambulatory Surgical Center 1951389063 Practice locations: Phoenix, AZ

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Care Compare: Ambulatory surgical center

Medicare Care Compare
Listed as
Akdhc Surgery Center LLCCCN 03C0001236
Medicare certification status
ActiveFrom the Provider of Services file

National Provider Directory

National Provider Directory
Tax ID family
Akdhc Surgery Center LLC5 organizations share this tax ID, including this one

Other organizations with this tax ID 4

Organizations that report the same tax identification number in the National Provider Directory.

Locations

2771 Silver Creek Rd
Ste 100
Bullhead City, AZ 86442
Phone (928) 704-7011

3333 E Camelback Rd
Ste 180
Phoenix, AZ 85018
Phone (602) 997-0484

Akdhc Llc File 749054
Los Angeles, CA 90074

Practitioners & affiliated clinicians

Practitioners 150

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

View all 150

NPI Registry JSON

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

{
    "created_epoch": "1177372800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1346469731",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3333 E CAMELBACK RD",
            "address_2": "SUITE 180",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850182322",
            "telephone_number": "602-997-0484",
            "fax_number": "602-224-3315"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3333 E CAMELBACK RD STE 180",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850182396",
            "telephone_number": "602-997-1098",
            "fax_number": "602-943-1453"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AKDHC SURGERY CENTER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-24",
        "last_updated": "2022-07-21",
        "status": "A",
        "authorized_official_last_name": "ESCOBEDO",
        "authorized_official_first_name": "ADONIS",
        "authorized_official_title_or_position": "CREDENTIALING MANAGER",
        "authorized_official_telephone_number": "602-759-6883",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Nephrology",
            "state": "AZ",
            "license": null,
            "primary": false
        },
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "537574",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Phoenix, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.