Organization Active NPI

Surgical Center at Cedar Knolls LLC

  • Ambulatory Surgical Clinic/Center
  • Cedar Knolls, NJ
National Provider Identifier
1528104080
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X
License
23363 Issued in NJ
Legal business name
SURGICAL CENTER AT CEDAR KNOLLS LLC
Practice address
197 Ridgedale Ave
Cedar Knolls, NJ 07927-2101
Phone
(973) 292-0700
Fax
(973) 292-0773
NPI assigned
Jan 30, 2007
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Ms. Kathryn Anderson, RN, BSN, MHA
Title
Administrator
Phone
(973) 292-0700

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ambulatory Surgical Clinic/Center 261QA1903X 23363 NJ Primary

Addresses

Primary practice location

197 Ridgedale Ave
Cedar Knolls, NJ 07927-2101

Mailing address

197 Ridgedale Ave
Cedar Knolls, NJ 07927-2101
Phone (973) 292-0700

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20070915000149 NJ Part B Supplier - Ambulatory Surgical Center 4789778150 Practice locations: Cedar Knolls, NJ

Care Compare: Ambulatory surgical center

Medicare Care Compare
Listed as
Surgical Center at Cedar Knolls LLCCCN 31C0001215
Medicare certification status
ActiveFrom the Provider of Services file

Laboratory certificates & supplier records

Derived by NPIMap

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

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
31D1057284Surgical Center at Cedar Knolls LLC197 Ridgedale Avenue, Suite 100, Cedar Knolls, NJ 07927Certificate of waiverAug 7, 2026

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

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.

NPI Registry JSON

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

{
    "created_epoch": "1170115200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1528104080",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "197 RIDGEDALE AVE",
            "city": "CEDAR KNOLLS",
            "state": "NJ",
            "postal_code": "079272101",
            "telephone_number": "973-292-0700",
            "fax_number": "973-292-0773"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "197 RIDGEDALE AVE",
            "city": "CEDAR KNOLLS",
            "state": "NJ",
            "postal_code": "079272101",
            "telephone_number": "973-292-0700",
            "fax_number": "973-292-0773"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SURGICAL CENTER AT CEDAR KNOLLS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-30",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "ANDERSON",
        "authorized_official_first_name": "KATHRYN",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "973-292-0700",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "RN, BSN, MHA"
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": "NJ",
            "license": "23363",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cedar Knolls, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.