Ambulatory Surgery Center of Centralia

Primary specialty

Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X

Legal business name

AMBULATORY SURGERY CENTER OF CENTRALIA

Practice address

1045 M L King Dr
Centralia, IL 62801-3001

Phone

(618) 532-3110

NPI assigned

Nov 8, 2022

Last updated

Nov 8, 2022By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Udaya LiyanageNPI 1972548287

Title

President

Phone

(618) 899-9200

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in IL

Enrollment records 1

Listed as

Ambulatory Surgery Center of Centralia Dba Surgery Center of CentraliaCCN 14C0001016

Medicare certification status

ActiveFrom the Provider of Services file

Practitioners 6

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.

• Udaya K Liyanage, MD

  • Surgery Physician
  • Mount Vernon, IL
  • NPI 1972548287
  Medicare reassignment NPD Authorized official
• Merrilee R Brandt, M.D.

  • Surgery Physician
  • Centralia, IL
  • NPI 1942243811
  Medicare reassignment NPD
• Thomas H. Nolen, D.P.M.

  • Foot & Ankle Surgery Podiatrist
  • Salem, IL
  • NPI 1083602718
  Medicare reassignment NPD
• Michael J. Schifano, D.O.

  • Obstetrics Physician
  • Marion, IL
  • NPI 1679507818
  Medicare reassignment NPD
• Mark Alden Murfin Jr., MD

  • Surgery Physician
  • Centralia, IL
  • NPI 1124029509
  NPD (past)
• Brian Michael Rapp, MD

  • Vascular Surgery Physician
  • Fort Smith, AR
  • NPI 1407014657
  NPD (past)

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

{
    "created_epoch": "1667865600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1667865600000",
    "number": "1508574518",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1307 E MCCORD ST",
            "city": "CENTRALIA",
            "state": "IL",
            "postal_code": "628013610"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1045 M L KING DR",
            "city": "CENTRALIA",
            "state": "IL",
            "postal_code": "628013001",
            "telephone_number": "618-532-3110"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AMBULATORY SURGERY CENTER OF CENTRALIA",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-11-08",
        "last_updated": "2022-11-08",
        "certification_date": "2022-11-08",
        "status": "A",
        "authorized_official_last_name": "LIYANAGE",
        "authorized_official_first_name": "UDAYA",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "618-899-9200"
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Nazir Ahmad, MD
• Amanda Allen
• Brenda S Allen, B.S
• Emily Ann Alli, CRNA
• Natalie Amason, FNP
• Ambulatory Surgery Center of Centralia, LLC (The Surgery Center of Centralia)
• Ambulatory Surgery Center of Centralia, LLC (Surgery Center of Centralia)
• Stephen T Ang, MD
• Beth Angle
• Paula Armstrong

• Ambulatory Surgical Clinic/Center in Centralia, IL
• Providers in Centralia, IL by specialty
• Ambulatory Surgical Clinic/Center in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 8, 2022; 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.