Surgery Center of Leawood, LLC

Primary specialty

Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X

License

S046016 Issued in KS

Legal business name

SURGERY CENTER OF LEAWOOD, LLC

Practice address

11413 Ash St Ste 100
Leawood, KS 66211-1692

Phone

(913) 661-9977

Fax

(913) 661-9577

NPI assigned

Nov 1, 2006

Organization subpart

No

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

Authorized official

Name

Thomas Charles Boldry, DPM

Title

Ceo

Phone

(816) 260-7893

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Ambulatory surgical center certification: CCN 17C0001051

Legal name

SURGERY CENTER OF LEAWOOD, LLC

Certification status

Active

Provider type (POS)

Ambulatory surgical center

Participating since

Jan 25, 2001

Last certification

Jul 26, 2016

Ownership / control type

Proprietary

Facility address

11413 Ash Street, Suite 100
Leawood, KS 66211

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

CLIA laboratory certificates

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Brian A Metz, MD

  • Otolaryngology Physician
  • Olathe, KS
  • NPI 1598761520
  NPD (past)

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

{
    "created_epoch": "1162339200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1437237401",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11413 ASH ST STE 100",
            "city": "LEAWOOD",
            "state": "KS",
            "postal_code": "662111692",
            "telephone_number": "913-661-9977",
            "fax_number": "913-661-9577"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11413 ASH ST STE 100",
            "city": "LEAWOOD",
            "state": "KS",
            "postal_code": "662111692",
            "telephone_number": "913-661-9977",
            "fax_number": "913-661-9577"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SURGERY CENTER OF LEAWOOD, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-01",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "BOLDRY",
        "authorized_official_first_name": "THOMAS",
        "authorized_official_middle_name": "CHARLES",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "816-260-7893",
        "authorized_official_credential": "DPM"
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": "KS",
            "license": "S046016",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE NUMBER",
            "identifier": "S046016",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jacob S Stueve, MD
• Mary Sullivan
• Summit Therapeutic Services, LLC
• Sunrise of Leawood
• Michael Andrew Surber, CRNA
• Surgicenter Anesthesia PA
• Cynthia P Surmaczewicz, PA-C
• Kathleen J Svejda, CRNA
• Lehi B. Swan, D.C.
• Eric Swanson, MD FACS FRCSC

• Ambulatory Surgical Clinic/Center in Leawood, KS
• Providers in Leawood, KS by specialty
• Ambulatory Surgical Clinic/Center in Kansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
• 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.