Peace River Surgery Center

Primary specialty

Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X

Legal business name

PEACE RIVER SURGERY CENTER

Practice address

4130 Tamiami TRL Unit 301
Port Charlotte, FL 33952-9207

Phone

(941) 629-5356

Fax

(941) 629-4987

NPI assigned

Mar 22, 2022

Organization subpart

No

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

Authorized official

Name

Dr. Nicolai Mejevoi, MDNPI 1427369131

Title

Medical Director

Phone

(941) 629-5356

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

Listed as

Peace River Surgery Center LLCCCN 10C0001741

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

Locations

Practitioners 3

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

• Nicolai G Mejevoi, MD

  • Interventional Cardiology Physician
  • Port Charlotte, FL
  • NPI 1427369131

  Cardiovascular Disease

  Medicare reassignment NPD Authorized official
• David Allen Hotchkiss, M.D.

  • Cardiovascular Disease Physician
  • Port Charlotte, FL
  • NPI 1548377435
  Medicare reassignment NPD
• Melody Strattan, D.O.

  • Interventional Cardiology Physician
  • Port Charlotte, FL
  • NPI 1487934097
  Medicare reassignment NPD

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

{
    "created_epoch": "1647907200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1682467200000",
    "number": "1467101907",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4130 TAMIAMI TRL UNIT 301",
            "city": "PORT CHARLOTTE",
            "state": "FL",
            "postal_code": "339529207",
            "telephone_number": "941-629-5356",
            "fax_number": "941-629-4987"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4130 TAMIAMI TRL UNIT 301",
            "city": "PORT CHARLOTTE",
            "state": "FL",
            "postal_code": "339529207",
            "telephone_number": "941-629-5356",
            "fax_number": "941-629-4987"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PEACE RIVER SURGERY CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-03-22",
        "last_updated": "2023-04-26",
        "certification_date": "2023-04-26",
        "status": "A",
        "authorized_official_last_name": "MEJEVOI",
        "authorized_official_first_name": "NICOLAI",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "941-629-5356",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Peace of Mind Internal Medicine PLLC Jennifer a Cooke Sole MBR
• Peace River Ankle & Foot, PL
• Peace River Cardiovascular Center
• Peace River Hma Nursing Center Inc (Peace River Nursing and Rehabilitation)
• Peace River Physical Therapy & Rehabilitation, LLC
• Peachland Chiropractic Health LLC
• Olena Pease, CRNA
• Eric Pecoraro
• Pediatric Dentistry of Port Charlotte
• Pediatrix Medical Group of Florida Inc

• Ambulatory Surgical Clinic/Center in Port Charlotte, FL
• Providers in Port Charlotte, FL by specialty
• Ambulatory Surgical Clinic/Center in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 26, 2023; 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.