BSC Reid Park LLC

Primary specialty

Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X

Legal business name

BSC REID PARK LLC

Doing business as

Banner Surgery Center Reid Park

Practice address

717 S Alvernon Way
Tucson, AZ 85711-5351

Phone

(520) 204-1495

NPI assigned

Jul 12, 2021

Organization subpart

No

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

Authorized official

Name

Aric Burke

Title

Director/Officer

Phone

(480) 689-8403

Specialties & licenses 1

Addresses

Other names 1

• Banner Surgery Center Reid Park Doing business as

Medicare fee-for-service enrollment

Enrolled in AZ

Enrollment records 1

Listed as

BSC Reid Park LLC Dba Banner Surgery Center Reid ParkCCN 03C0001453

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

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

{
    "created_epoch": "1626048000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1626048000000",
    "number": "1508438375",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2355 E CAMELBACK RD STE 700",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850169044"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "717 S ALVERNON WAY",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857115351",
            "telephone_number": "520-204-1495"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BSC REID PARK LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-07-12",
        "last_updated": "2021-07-12",
        "certification_date": "2021-07-12",
        "status": "A",
        "authorized_official_last_name": "BURKE",
        "authorized_official_first_name": "ARIC",
        "authorized_official_title_or_position": "DIRECTOR/OFFICER",
        "authorized_official_telephone_number": "480-689-8403"
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Banner Surgery Center Reid Park",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Brandon Brym, PT,DPT
• Skye Bryner - Engle
• Carol Ann Bryniarski, NURSE PRACTITIONER
• Susan Bryning, NURSE PRACTITIONER
• Thomas L Brysacz, MD
• Btaz LLC
• Annemarie Buadu, MD
• Lawrence Danso Buadu, MD
• Ahmed Buazza, M.D.
• James Michael Bub, D.C.

• 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 Jul 12, 2021; 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.