NPIMap

Organization Active NPI

North Florida Surgery Center Inc

Doing business as North Florida Surgery Center

  • Ambulatory Surgical Clinic/Center
  • Lake City, FL
National Provider Identifier
1467582437
Registry record updated Oct 16, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X
License
957 Issued in FL
Legal business name
NORTH FLORIDA SURGERY CENTER INC
Doing business as
North Florida Surgery Center
Practice address
256 SW Professional GLN
Suite 101
Lake City, FL 32025-1104
Phone
(386) 758-8937
Fax
(386) 755-2169
NPI assigned
Mar 7, 2007
Last updated
Oct 16, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 16, 2008

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

Authorized official

Name
Dr. Mohammad A. Faisal, M.D.
Title
President
Phone
(386) 758-8937

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ambulatory Surgical Clinic/Center 261QA1903X 957 FL Primary

Addresses

Primary practice location

256 SW Professional GLN
Suite 101
Lake City, FL 32025-1104

Mailing address

256 SW Professional GLN
Suite 101
Lake City, FL 32025-1104
Phone (386) 758-8937

Other identifiers 4

IdentifierTypeStateIssuer
235726OtherFLAVMED
079210100MedicaidFL
65SOtherFLBLUE CROSS BLUE SHIELD
490003028OtherFLRAILROAD MEDICARE

Other names 1

  • North Florida Surgery Center Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20110728000586 FL Part B Supplier - Ambulatory Surgical Center 5991782450 Practice locations: Lake City, FL

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Care Compare: Ambulatory surgical center

Medicare Care Compare
Listed as
North Florida Surgery Center IncCCN 10C0001262
Medicare certification status
ActiveFrom the Provider of Services file

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 8

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.

NPI Registry JSON

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

{
    "created_epoch": "1173225600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1224115200000",
    "number": "1467582437",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "256 SW PROFESSIONAL GLN",
            "address_2": "SUITE 101",
            "city": "LAKE CITY",
            "state": "FL",
            "postal_code": "320251104",
            "telephone_number": "386-758-8937",
            "fax_number": "386-755-2169"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "256 SW PROFESSIONAL GLN",
            "address_2": "SUITE 101",
            "city": "LAKE CITY",
            "state": "FL",
            "postal_code": "320251104",
            "telephone_number": "386-758-8937",
            "fax_number": "386-755-2169"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTH FLORIDA SURGERY CENTER INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-07",
        "last_updated": "2008-10-16",
        "status": "A",
        "authorized_official_last_name": "FAISAL",
        "authorized_official_first_name": "MOHAMMAD",
        "authorized_official_middle_name": "A.",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "386-758-8937",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": "FL",
            "license": "957",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AVMED",
            "identifier": "235726",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "079210100",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "65S",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD  MEDICARE",
            "identifier": "490003028",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "North Florida Surgery Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Lake City, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 16, 2008; 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.