Meridian Center for Surgical Excellence

Primary specialty

Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X

Legal business name

MERIDIAN CENTER FOR SURGICAL EXCELLENCE

Practice address

19801 SW 72ND Ave
Suite 170
Tualatin, OR 97062-8351

Phone

(503) 783-0542

Fax

(503) 783-0545

NPI assigned

Sep 19, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Timothy Patrick Connall, MD

Title

Medical Director

Phone

(503) 783-0542

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Ambulatory surgical center certification: CCN 38C0001088

Legal name

Meridian Center for Surgical Excellence

Certification status

Active

Provider type (POS)

Ambulatory surgical center

Participating since

Jun 30, 2008

Last certification

Jun 30, 2008

Ownership / control type

Proprietary

Facility address

19801 SW 72nd Avenue, Suite 170
Tualatin, OR 97062

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

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

{
    "created_epoch": "1190160000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1190160000000",
    "number": "1366638843",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19801 SW 72ND AVE",
            "address_2": "SUITE 170",
            "city": "TUALATIN",
            "state": "OR",
            "postal_code": "970628351",
            "telephone_number": "503-783-0542",
            "fax_number": "503-783-0545"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19801 SW 72ND AVE",
            "address_2": "SUITE 170",
            "city": "TUALATIN",
            "state": "OR",
            "postal_code": "970628351",
            "telephone_number": "503-783-0542",
            "fax_number": "503-783-0545"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MERIDIAN CENTER FOR SURGICAL EXCELLENCE",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-09-19",
        "last_updated": "2007-09-19",
        "status": "A",
        "authorized_official_last_name": "CONNALL",
        "authorized_official_first_name": "TIMOTHY",
        "authorized_official_middle_name": "PATRICK",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "503-783-0542",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Melody Jones, Pmhnp, LLC
• Melody Jones, Pmhnp, LLC
• Debra L Mende, R.N.
• Melissa Brook Mendez
• Linn Rey Menzie Sr., LCSW
• Meridian Family Care, LLC
• Meridian Park Oncology LLC
• Meridian Park Radiation Oncolog Center, Inc
• Meridian Park Radiation Oncology Center, Inc.
• Samantha Merz

• Ambulatory Surgical Clinic/Center in Tualatin, OR
• Providers in Tualatin, OR by specialty
• Ambulatory Surgical Clinic/Center in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 19, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
• 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.