NPIMap

Organization Active NPI

Hilltop Ambulatory Surgery Center LLC

  • Ambulatory Surgical Clinic/Center
  • Lyndhurst, OH
National Provider Identifier
1396077582
Registry record updated May 17, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X
License
0965AS Issued in OH
Legal business name
HILLTOP AMBULATORY SURGERY CENTER LLC
Doing business as
Legacy Surgery Center
Practice address
5035 Mayfield Rd
Suiite # 100
Lyndhurst, OH 44124-2688
Phone
(216) 923-0666
Fax
(216) 432-1136
NPI assigned
Feb 12, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 17, 2017

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

Authorized official

Name
Dr. Rodney A. Green, M.D.NPI 1831280213
Title
Medical Director
Phone
(440) 449-8880

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ambulatory Surgical Clinic/Center 261QA1903X 0965AS OH Primary

Addresses

Primary practice location

5035 Mayfield Rd
Suiite # 100
Lyndhurst, OH 44124-2688

Mailing address

5035 Mayfield Rd
Suite # 100
Lyndhurst, OH 44124-2688
Phone (216) 923-0666

Other identifiers 1

IdentifierTypeStateIssuer
0062559MedicaidOH

Other names 1

  • Legacy 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
O20120802000587 OH Part B Supplier - Ambulatory Surgical Center 3971759150 Receives reassigned benefits from 2 practitioners
Practice locations: Lyndhurst, OH

Care Compare: Ambulatory surgical center

Medicare Care Compare
Listed as
Hilltop Ambulatory Surgery Center LLCCCN 36C0001268
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
36D1104951Legacy Surgery Center5035 Mayfield Road Suite 100, Lyndhurst, OH 44124Certificate of waiverSep 13, 2027

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 3

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": "1265932800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1494979200000",
    "number": "1396077582",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5035 MAYFIELD RD",
            "address_2": "SUITE # 100",
            "city": "LYNDHURST",
            "state": "OH",
            "postal_code": "441242688",
            "telephone_number": "216-923-0666",
            "fax_number": "216-432-1136"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5035 MAYFIELD RD",
            "address_2": "SUIITE # 100",
            "city": "LYNDHURST",
            "state": "OH",
            "postal_code": "441242688",
            "telephone_number": "216-923-0666",
            "fax_number": "216-432-1136"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HILLTOP AMBULATORY SURGERY CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-02-12",
        "last_updated": "2017-05-17",
        "status": "A",
        "authorized_official_last_name": "GREEN",
        "authorized_official_first_name": "RODNEY",
        "authorized_official_middle_name": "A.",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "440-449-8880",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": "OH",
            "license": "0965AS",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0062559",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Legacy Surgery Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Lyndhurst, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 17, 2017; 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.