Cedarcrest Surgery Center LLC

Primary specialty

Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X

Legal business name

CEDARCREST SURGERY CENTER LLC

Practice address

2200 Cedar Crest Dr Ste B
Rice Lake, WI 54868-5502

Phone

(715) 537-4960

NPI assigned

Jan 25, 2023

Organization subpart

No

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

Authorized official

Name

Kelly Renee Flach

Title

Executive Director

Phone

(715) 520-3877

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in WI

Enrollment records 1

Listed as

Cedarcrest Surgery Center LLCCCN 52C0001150

Medicare certification status

ActiveFrom the Provider of Services file

Tax ID family

Cedarcrest Surgery Center2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

• Cedarcrest Surgery Center LLC

  • Ambulatory Surgical Clinic/Center
  • Rice Lake, WI
  • NPI 1841011764
  NPD tax ID

Locations

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

{
    "created_epoch": "1674604800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1761696000000",
    "number": "1376259275",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2200 CEDAR CREST DR STE B",
            "city": "RICE LAKE",
            "state": "WI",
            "postal_code": "548685500",
            "telephone_number": "715-537-4930",
            "fax_number": "715-537-4961"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2200 CEDAR CREST DR STE B",
            "city": "RICE LAKE",
            "state": "WI",
            "postal_code": "548685502",
            "telephone_number": "715-537-4960"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CEDARCREST SURGERY CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-01-25",
        "last_updated": "2025-10-29",
        "certification_date": "2025-10-29",
        "status": "A",
        "authorized_official_last_name": "FLACH",
        "authorized_official_first_name": "KELLY",
        "authorized_official_middle_name": "RENEE",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "715-520-3877"
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Eric N Carlsen, MD
• Wyatt Carlson
• Kyle Carlton, D.D.S
• William Scott Carpenter, MD
• Kay Loree Case, PA-C
• Cedarcrest Surgery Center LLC
• Cek Family Companion Care
• Charles Kent Meng O D LTD
• Srinivas S Chetty, MD
• Chippewa Valley Orthopedics and Sports Medicine Clinic, SC

• Ambulatory Surgical Clinic/Center in Rice Lake, WI
• Providers in Rice Lake, WI by specialty
• Ambulatory Surgical Clinic/Center in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 29, 2025; 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.