Surgicenter of Greater Milwaukee, LLC

Primary specialty

Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X

Legal business name

SURGICENTER OF GREATER MILWAUKEE, LLC

Practice address

3223 S 103Rd St
Milwaukee, WI 53227-4103

Phone

(414) 328-5800

Fax

(414) 328-5805

NPI assigned

Sep 14, 2006

Organization subpart

No

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

Authorized official

Name

Mr. Marc Cadieux

Title

Corporate VP and Cfo

Phone

(414) 266-6226

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Surgicenter of Greater Milwaukee, Inc. Former legal business name

Medicare fee-for-service enrollment

Enrolled in WI

Enrollment records 1

Ambulatory surgical center certification: CCN 52C0001014

Legal name

SURGICENTER OF GREATER MILWAUKEE

Certification status

Active

Provider type (POS)

Ambulatory surgical center

Participating since

Feb 4, 1992

Last certification

Sep 10, 2013

Ownership / control type

Non-Profit

Facility address

3223 S 103Rd St
Milwaukee, WI 53227

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

CLIA laboratory certificates

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

{
    "created_epoch": "1158192000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1459209600000",
    "number": "1447355243",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 88842",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532880001",
            "telephone_number": "414-328-5800",
            "fax_number": "414-328-5805"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3223 S 103RD ST",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532274103",
            "telephone_number": "414-328-5800",
            "fax_number": "414-328-5805"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SURGICENTER OF GREATER MILWAUKEE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-14",
        "last_updated": "2016-03-29",
        "status": "A",
        "authorized_official_last_name": "CADIEUX",
        "authorized_official_first_name": "MARC",
        "authorized_official_title_or_position": "CORPORATE VP AND CFO",
        "authorized_official_telephone_number": "414-266-6226",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "41906900",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Surgicenter of Greater Milwaukee, Inc.",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

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• Providers in Milwaukee, WI by specialty
• Ambulatory Surgical Clinic/Center in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 29, 2016; 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.