Organization Active NPI

Hudson Yards Surgery Center, LLC

  • Ambulatory Surgical Clinic/Center
  • New York, NY
National Provider Identifier
1376054007
Registry record updated Jan 17, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X
Legal business name
HUDSON YARDS SURGERY CENTER, LLC
Practice address
450 West 31St Street, 2S
New York, NY 10001
Phone
(212) 604-9800
Fax
(212) 242-4757
NPI assigned
Oct 20, 2017
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 17, 2023

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

Authorized official

Name
John J Khadem, MD
Title
Owner
Phone
(212) 604-9800

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207W00000X
Ambulatory Surgical Clinic/Center 261QA1903X Primary

Addresses

Primary practice location

450 West 31St Street, 2S
New York, NY 10001

Mailing address

20 W 13TH St
New York, NY 10011-7995
Phone (212) 604-9800

Other names 2

  • Hudson Specialty Surgery Center Doing business as
  • USSC, LLC Former legal business name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20180626000792 NY Part B Supplier - Ambulatory Surgical Center 7618222035 Receives reassigned benefits from 2 practitioners
Practice locations: New York, NY

Care Compare: Ambulatory surgical center

Medicare Care Compare
Listed as
Hudson Yards Surgery Center LLCCCN 33C0001188
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
33D2169464Hudson Yards Surgery Center LLC450 W 31St St - Unit 2S, New York, NY 10001Certificate of waiverMar 26, 2027

National Provider Directory

National Provider Directory

Locations

20 W 13th St
New York, NY 10011
Phone (212) 604-9800

450 W 31st St
#2S
New York, NY 10001
Phone (212) 604-9800

450 W 31st St
Ste 2S
New York, NY 10001
Phone (212) 604-9800

Practitioners & affiliated clinicians

Practitioners 2

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

NPI Registry JSON

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

{
    "created_epoch": "1508457600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1673913600000",
    "number": "1376054007",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20 W 13TH ST",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100117995",
            "telephone_number": "212-604-9800",
            "fax_number": "212-242-4757"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "450 WEST 31ST STREET, 2S",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "10001",
            "telephone_number": "212-604-9800",
            "fax_number": "212-242-4757"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HUDSON YARDS SURGERY CENTER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-10-20",
        "last_updated": "2023-01-17",
        "certification_date": "2023-01-17",
        "status": "A",
        "authorized_official_last_name": "KHADEM",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "212-604-9800",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Ophthalmology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Hudson Specialty Surgery Center",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "USSC, LLC",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in New York, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 17, 2023; 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.