Organization Active NPI

Advanced Urology Surgery Center

  • Ambulatory Surgical Clinic/Center
  • Snellville, GA
National Provider Identifier
1376884585
Registry record updated Jan 7, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X
Legal business name
ADVANCED UROLOGY SURGERY CENTER
Practice address
1557 Janmar Rd
Snellville, GA 30078-5686
Phone
(678) 344-8900
Fax
(678) 666-5201
NPI assigned
Mar 13, 2013
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 7, 2025

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

Authorized official

Name
Mr. Beemal Shah
Title
Ceo
Phone
(706) 951-8657

Specialties & licenses 1

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

Addresses

Primary practice location

1557 Janmar Rd
Snellville, GA 30078-5686

Mailing address

1551 Janmar Rd
Snellville, GA 30078-5606
Phone (678) 344-8900

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20131106000131 GA Part B Supplier - Ambulatory Surgical Center 7012142714 Practice locations: Snellville, GA

Care Compare: Ambulatory surgical center

Medicare Care Compare
Listed as
Advanced Urology Surgery CenterCCN 11C0001404
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
11D2057896Advanced Urology Surgery Center, LLC1557 Janmar Road, Suite 200, Snellville, GA 30078Certificate of waiverApr 24, 2027

National Provider Directory

National Provider Directory

Member of 1

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

Locations

1557 Janmar Rd
Ste 200
Snellville, GA 30078

Practitioners & affiliated clinicians

Practitioners 1

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": "1363132800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1736208000000",
    "number": "1376884585",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1551 JANMAR RD",
            "city": "SNELLVILLE",
            "state": "GA",
            "postal_code": "300785606",
            "telephone_number": "678-344-8900",
            "fax_number": "678-666-5201"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1557 JANMAR RD",
            "city": "SNELLVILLE",
            "state": "GA",
            "postal_code": "300785686",
            "telephone_number": "678-344-8900",
            "fax_number": "678-666-5201"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ADVANCED UROLOGY SURGERY CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-03-13",
        "last_updated": "2025-01-07",
        "certification_date": "2025-01-07",
        "status": "A",
        "authorized_official_last_name": "SHAH",
        "authorized_official_first_name": "BEEMAL",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "706-951-8657",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Snellville, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 7, 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.