Pavonia Surgical Center, LLC

Primary specialty

Multi-Specialty Clinic/CenterTaxonomy code 261QM1300X

Legal business name

PAVONIA SURGICAL CENTER, LLC

Doing business as

PRISM Surgery Center at Union

Practice address

855 Lehigh Ave Ste 203
Union, NJ 07083-7631

Phone

(201) 216-1700

NPI assigned

Sep 22, 2006

Last updated

Feb 5, 2024By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Lauren A Magnifico

Title

VP, ASC Operations

Phone

(201) 216-1700

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• PRISM Surgery Center at Union Doing business as

Medicare fee-for-service enrollment

Enrolled in NJ

Enrollment records 1

Listed as

Pavonia Surgery Center IncCCN 31C0001030

Medicare certification status

ActiveFrom the Provider of Services file

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

CLIA laboratory certificates

Member of 1

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

• Virtua - West Jersey Health System, Inc.

  dba Virtua Home Care at West Jersey

  • Home Health Agency
  • Marlton, NJ
  • NPI 1316943004

  Member Of

  NPD member

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.

• William H. Constad, M.D.

  • Ophthalmology Physician
  • Jersey City, NJ
  • NPI 1437267630
  NPD (past)

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

{
    "created_epoch": "1158883200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1707091200000",
    "number": "1396844429",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "420 MOUNTAIN AVE FL 4",
            "city": "NEW PROVIDENCE",
            "state": "NJ",
            "postal_code": "079742736"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "855 LEHIGH AVE STE 203",
            "city": "UNION",
            "state": "NJ",
            "postal_code": "070837631",
            "telephone_number": "201-216-1700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PAVONIA SURGICAL CENTER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-22",
        "last_updated": "2024-02-05",
        "certification_date": "2024-02-05",
        "status": "A",
        "authorized_official_last_name": "MAGNIFICO",
        "authorized_official_first_name": "LAUREN",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "VP, ASC OPERATIONS",
        "authorized_official_telephone_number": "201-216-1700"
    },
    "taxonomies": [
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "52773021",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "PRISM Surgery Center at Union",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Yashvi Patel, DO
• Patrick G Tempera MD PC
• Matthew Quinn Patterson, MS, LAT, ATC
• Erica Patusco, O.T.R.
• Rebecca Rose Pavlick
• PDG of Union (The Apprehensive Patient)
• Lisa Pedalino
• Rachel Pekarsky, MS, CCC-SLP
• Nicola Pemberton, M.D.
• Belinda Pena

• Multi-Specialty Clinic/Center in Union, NJ
• Providers in Union, NJ by specialty
• Multi-Specialty Clinic/Center in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 5, 2024; 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.