Overlake Ambulatory Surgery Center, LLC

Primary specialty

Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X

Legal business name

OVERLAKE AMBULATORY SURGERY CENTER, LLC

Doing business as

Overlake Surgery Center LLC

Practice address

1135 116TH Ave NE
300
Bellevue, WA 98004

Phone

(425) 709-2500

Fax

(425) 709-2323

NPI assigned

Nov 1, 2006

Last updated

Oct 29, 2012By 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

Wendy J Taylor

Title

Executive Director

Phone

(425) 709-7523

Specialties & licenses 1

Addresses

Other identifiers 4

Other names 1

• Overlake Surgery Center LLC Doing business as

Medicare fee-for-service enrollment

Enrolled in WA

Enrollment records 1

Listed as

Overlake Ambulatory Surgery Center LLCCCN 50C0001185

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

Member of 3

Organizations this organization is a member of, according to the National Provider Directory.

• Overlake Medical Center & Clinics

  • General Acute Care Hospital
  • Bellevue, WA
  • NPI 1861432726

  Member Of

  NPD member
• Pacmed Clinics

  • Multi-Specialty Clinic/Center
  • Lynnwood, WA
  • NPI 1477594356

  Member Of

  NPD member
• Proliance Surgeons Inc., P.S.

  dba Northwest Orthopaedic Physicians

  • Orthopaedic Surgery Physician
  • Bellevue, WA
  • NPI 1043259096

  Member Of

  NPD member

Locations

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

{
    "created_epoch": "1162339200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1351468800000",
    "number": "1528145778",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1135 116TH AVE NE",
            "address_2": "SUITE 300",
            "city": "BELLEVUE",
            "state": "WA",
            "postal_code": "98004",
            "telephone_number": "425-709-2500",
            "fax_number": "425-709-2323"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1135 116TH AVE NE",
            "address_2": "300",
            "city": "BELLEVUE",
            "state": "WA",
            "postal_code": "98004",
            "telephone_number": "425-709-2500",
            "fax_number": "425-709-2323"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OVERLAKE AMBULATORY SURGERY CENTER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-01",
        "last_updated": "2012-10-29",
        "status": "A",
        "authorized_official_last_name": "TAYLOR",
        "authorized_official_first_name": "WENDY",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "425-709-7523"
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PREMERA BLUE CROSS",
            "identifier": "362",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7102890",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LABOR & INDUSTRIES",
            "identifier": "0141317",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "REGENCE BLUE SHIELD",
            "identifier": "903004",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Overlake Surgery Center LLC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Desiree L Otto, MD
• Yanhua Ou, LA.C
• Rania Ouzmi, RDA
• Over Lake Medical Center
• Linda Overbay, PT
• Overlake Arthritis and Osteoporosis Center, PLLC
• Overlake Arthritis and Osteoporosis Center, PLLC
• Overlake Breast Imaging LLC (Overlake Breast MRI)
• Overlake Colon & Rectal Clinic, PLLC
• Overlake Eyecare P S

• Ambulatory Surgical Clinic/Center in Bellevue, WA
• Providers in Bellevue, WA by specialty
• Ambulatory Surgical Clinic/Center in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 29, 2012; 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.