Organization Active NPI

Medina-Summit Ambulatory Surgery Center

Doing business as The Medina Surgery Center

  • Ambulatory Surgical Clinic/Center
  • Medina, OH
National Provider Identifier
1366761397
Registry record updated Mar 30, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X
Legal business name
MEDINA-SUMMIT AMBULATORY SURGERY CENTER
Doing business as
The Medina Surgery Center
Practice address
3780 Medina Rd
Medina, OH 44256-5947
Phone
(330) 952-0014
Fax
(330) 952-0015
NPI assigned
Jun 1, 2010
Last updated
Mar 30, 2011By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 30, 2011

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

Authorized official

Name
Ms. Victoria J. Meshekow, RN
Title
Administrator
Phone
(330) 309-5415

Specialties & licenses 1

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

Addresses

Primary practice location

3780 Medina Rd
Medina, OH 44256-5947

Mailing address

3780 Medina Rd
Suite 120
Medina, OH 44256-5947
Phone (330) 952-0014

Other names 1

  • The Medina Surgery Center Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20110325000820 OH Part B Supplier - Ambulatory Surgical Center 2961685003 Practice locations: Medina, OH

Care Compare: Ambulatory surgical center

Medicare Care Compare
Listed as
Medinasummit Ambulatory Surgery CenterCCN 36C0001263
Medicare certification status
ActiveFrom the Provider of Services file

Laboratory certificates & supplier records

Derived by NPIMap

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

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
36D2010142Medina Surgery Center, the3780 Medina Road, Suite 120, Medina, OH 44256Certificate of waiverJul 20, 2028

National Provider Directory

National Provider Directory

Member of 1

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

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1275350400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1301443200000",
    "number": "1366761397",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3780 MEDINA RD",
            "address_2": "SUITE 120",
            "city": "MEDINA",
            "state": "OH",
            "postal_code": "442565947",
            "telephone_number": "330-952-0014",
            "fax_number": "330-952-0015"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3780 MEDINA RD",
            "city": "MEDINA",
            "state": "OH",
            "postal_code": "442565947",
            "telephone_number": "330-952-0014",
            "fax_number": "330-952-0015"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEDINA-SUMMIT AMBULATORY SURGERY CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-06-01",
        "last_updated": "2011-03-30",
        "status": "A",
        "authorized_official_last_name": "MESHEKOW",
        "authorized_official_first_name": "VICTORIA",
        "authorized_official_middle_name": "J.",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "330-309-5415",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "RN"
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "The Medina Surgery Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Medina, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 30, 2011; 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.