Speedway Surgical Specialists, LLC

Primary specialty

Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X

Legal business name

SPEEDWAY SURGICAL SPECIALISTS, LLC

Practice address

6442 E Speedway Blvd Ste 152
Tucson, AZ 85710-1134

Phone

(520) 771-8175

Fax

(520) 771-9402

NPI assigned

Jul 2, 2021

Last updated

May 10, 2023By the provider in NPPES

Organization subpart

Yes

Parent organization

SPEEDWAY SURGICAL SPECIALISTS, LLCAs reported in NPPES

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

Authorized official

Name

Amy Namanny, PHARMD/MBA

Title

Board Member

Phone

(520) 777-4090

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in AZ

Enrollment records 1

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1508437385. Details of each certification follow.

• CCN 03C0001464 Ambulatory surgical center · Active · Name & address match · Details

Ambulatory surgical center certification: CCN 03C0001464

Legal name

SPEEDWAY SURGICAL SPECIALISTS LLC

Certification status

Active

Provider type (POS)

Ambulatory surgical center

Participating since

Sep 6, 2022

Last certification

Aug 19, 2022

Ownership / control type

Proprietary

Facility address

6442 E Speedway Blvd, Ste 152
Tucson, AZ 85710

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

CLIA laboratory certificates

Part of

Speedway Surgical Specialists LLC

Locations

Practitioners 1

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.

• Thomas Bobka, MD

  • Vascular Surgery Physician
  • Tucson, AZ
  • NPI 1649613894
  Medicare reassignment NPD

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

{
    "created_epoch": "1625184000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1683676800000",
    "number": "1508437385",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6442 E SPEEDWAY BLVD STE 152",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857100013",
            "telephone_number": "520-771-8175",
            "fax_number": "520-771-9194"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6442 E SPEEDWAY BLVD STE 152",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857101134",
            "telephone_number": "520-771-8175",
            "fax_number": "520-771-9402"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SPEEDWAY SURGICAL SPECIALISTS, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "SPEEDWAY SURGICAL SPECIALISTS, LLC",
        "enumeration_date": "2021-07-02",
        "last_updated": "2023-05-10",
        "certification_date": "2023-05-10",
        "status": "A",
        "authorized_official_last_name": "NAMANNY",
        "authorized_official_first_name": "AMY",
        "authorized_official_title_or_position": "BOARD MEMBER",
        "authorized_official_telephone_number": "520-777-4090",
        "authorized_official_credential": "PHARMD/MBA"
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Spectrum Healthcare Group, Inc.
• Speech and Swallow Consultants
• Speech Center of Southern Arizona
• Speech Solutions Arizona PLLC (Speech Solutions)
• Speech Therapy Group of Tucson PLLC
• Grace Anne Miller Speer, DO
• Samuel Charles Speer
• Shana Speer
• Mark Alan Speetzen
• Douglas J Spegman, MD

• Ambulatory Surgical Clinic/Center in Tucson, AZ
• Providers in Tucson, AZ by specialty
• Ambulatory Surgical Clinic/Center in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 10, 2023; 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.