Active NPI
Speedway Surgical Specialists, LLC
- Ambulatory Surgical Clinic/Center
- Tucson, AZ
National Provider Identifier
1508437385
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Ambulatory Surgical Clinic/Center
- 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
- Organization subpart
- Yes
- Parent organization
- SPEEDWAY SURGICAL SPECIALISTS, LLC
NPPES NPI Registry
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
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Ambulatory Surgical Clinic/Center | 261QA1903X | Primary |
Addresses
Primary practice location
6442 E Speedway Blvd Ste 152
Tucson, AZ 85710-1134
Mailing address
6442 E Speedway Blvd Ste 152
Tucson, AZ 85710-0013
Phone (520) 771-8175
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in AZ
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20220720000553 | AZ | Part B Supplier - Ambulatory Surgical Center | 6709267925 |
Receives reassigned benefits from 1 practitioner Practice locations: Tucson, AZ |
Laboratory certificates & supplier records
Derived by NPIMapThese CMS records do not include an NPI. They are shown because their name and street address match this provider’s.
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 03D2234140 | Speedway Surgical Specialists | Certificate of waiver | Aug 26, 2027 |
National Provider Directory
National Provider Directory- Part of
- Speedway Surgical Specialists LLC
Practitioners & affiliated clinicians
Practitioners 1
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
NPI Registry JSON
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": []
}
Other providers in Tucson, AZ
Sources for this page
- 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.
- 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.