NPIMap

Organization Active NPI

Tampa Bay Center for Specialized Surgery Inc

Doing business as Center for Specialized Surgery

  • Ambulatory Surgical Clinic/Center
  • Tampa, FL
National Provider Identifier
1366499923
Registry record updated Apr 10, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X
License
912 Issued in FL
Legal business name
TAMPA BAY CENTER FOR SPECIALIZED SURGERY INC
Doing business as
Center for Specialized Surgery
Practice address
2808 W Dr Martin Luther King Jr Blvd
Tampa, FL 33607-6306
Phone
(813) 874-2040
Fax
(813) 876-3438
NPI assigned
May 28, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 10, 2013

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

Authorized official

Name
Ms. Mary Elizabeth Dykema
Title
Facility Administator
Phone
(813) 874-2040

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ambulatory Surgical Clinic/Center 261QA1903X 912 FL Primary

Addresses

Primary practice location

2808 W Dr Martin Luther King Jr Blvd
Tampa, FL 33607-6306

Mailing address

PO Box 152199
Tampa, FL 33684-2199
Phone (813) 874-2040

Other identifiers 4

IdentifierTypeStateIssuer
2173001OtherFLAETNA
593535954200OtherOHBWC
162422500OtherKYACS
912OtherFLSTATE OF FLORIDA

Other names 1

  • CENTER FOR SPECIALIZED SURGERY Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20051004000033 FL Part B Supplier - Ambulatory Surgical Center 9830124379 Practice locations: Tampa, FL

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1148774400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1365552000000",
    "number": "1366499923",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 152199",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336842199",
            "telephone_number": "813-874-2040",
            "fax_number": "813-876-3438"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2808 W DR MARTIN LUTHER KING JR BLVD",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336076306",
            "telephone_number": "813-874-2040",
            "fax_number": "813-876-3438"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TAMPA BAY CENTER FOR SPECIALIZED SURGERY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-28",
        "last_updated": "2013-04-10",
        "status": "A",
        "authorized_official_last_name": "DYKEMA",
        "authorized_official_first_name": "MARY",
        "authorized_official_middle_name": "ELIZABETH",
        "authorized_official_title_or_position": "FACILITY ADMINISTATOR",
        "authorized_official_telephone_number": "813-874-2040",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": "FL",
            "license": "912",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "2173001",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BWC",
            "identifier": "593535954200",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ACS",
            "identifier": "162422500",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE OF FLORIDA",
            "identifier": "912",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "CENTER FOR SPECIALIZED SURGERY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Tampa, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 10, 2013; 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.