Cleveland ASC LLC

Primary specialty

Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X

License

0448AS Issued in OH

Legal business name

CLEVELAND ASC LLC

Doing business as

Cleveland Surgical Suites

Practice address

5106 Wilson Mills Rd
Richmond Heights, OH 44143-3006

Phone

(440) 461-2570

Fax

(440) 461-7109

NPI assigned

Jan 20, 2006

Last updated

Apr 20, 2023By 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

James Wachter

Title

Chief Medical Officer

Phone

(636) 227-2600

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• Cleveland Surgical Suites Doing business as

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

{
    "created_epoch": "1137715200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1681948800000",
    "number": "1417937756",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15933 CLAYTON RD STE 210",
            "city": "BALLWIN",
            "state": "MO",
            "postal_code": "630112172",
            "telephone_number": "636-227-2600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5106 WILSON MILLS RD",
            "city": "RICHMOND HEIGHTS",
            "state": "OH",
            "postal_code": "441433006",
            "telephone_number": "440-461-2570",
            "fax_number": "440-461-7109"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CLEVELAND ASC LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-01-20",
        "last_updated": "2023-04-20",
        "certification_date": "2023-04-20",
        "status": "A",
        "authorized_official_last_name": "WACHTER",
        "authorized_official_first_name": "JAMES",
        "authorized_official_title_or_position": "CHIEF MEDICAL OFFICER",
        "authorized_official_telephone_number": "636-227-2600"
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": "OH",
            "license": "0448AS",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2060639",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "490003603",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Cleveland Surgical Suites",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Cleveland Surgical Suites",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Eric Choate
• Sherman Chu
• Thomas Salvatore Ciresi Jr.
• City of Richmond Heights
• Tamia Clemons
• Kyle Cleveland, D.O.
• Coburn Solutions LLC
• Allyson Elizabeth Cochet, M.D.
• Bruce Allen Coffey Jr.
• Sheila Coleman, NP-C

• Ambulatory Surgical Clinic/Center in Richmond Heights, OH
• Providers in Richmond Heights, OH by specialty
• Ambulatory Surgical Clinic/Center in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 20, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.