Kissimmee Surgicare LTD

Primary specialty

Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X

License

987 Issued in FL

Legal business name

KISSIMMEE SURGICARE LTD

Practice address

2275 N Central Ave
Kissimmee, FL 34741-2342

Phone

(407) 870-0573

Fax

(407) 870-1859

NPI assigned

Apr 10, 2006

Last updated

Sep 8, 2026By 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

David McKnight

Title

VP/Cfo

Phone

(972) 789-2816

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

Listed as

Kissimmee Surgicare LTDCCN 10C0001131

Medicare certification status

ActiveFrom the Provider of Services file

Networks

• Freedom Health HMO NetworkPlans: Freedom Platinum Rewards Plan Rx (HMO) (H5427-102-000, H5427); Freedom VIP Care (HMO C-SNP) (H5427-070-000, H5427); Freedom VIP Rewards (HMO C-SNP) (H5427-108-000, H5427); Freedom VIP Rewards (HMO C-SNP) (H5427-099-000, H5427); Freedom Platinum Rewards Plan Rx (HMO) (H5427-107-000, H5427); Freedom Máximo (HMO-POS) (H5427-113-000, H5427); Freedom Savings Plan (HMO) (H5427-052-000, H5427); Freedom Platinum Rewards Plan Rx (HMO) (H5427-096-000, H5427); Freedom Platinum Rewards Plan Rx (HMO) (H5427-105-000, H5427); Freedom Medi-Medi Full (HMO D-SNP) (H5427-087-000, H5427)…

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

{
    "created_epoch": "1144627200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1788825600000",
    "number": "1538122684",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2275 N CENTRAL AVE",
            "city": "KISSIMMEE",
            "state": "FL",
            "postal_code": "347412342",
            "telephone_number": "407-870-0573",
            "fax_number": "407-870-1859"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2275 N CENTRAL AVE",
            "city": "KISSIMMEE",
            "state": "FL",
            "postal_code": "347412342",
            "telephone_number": "407-870-0573",
            "fax_number": "407-870-1859"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KISSIMMEE SURGICARE LTD",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-04-10",
        "last_updated": "2026-09-08",
        "certification_date": "2026-09-08",
        "status": "A",
        "authorized_official_last_name": "MCKNIGHT",
        "authorized_official_first_name": "DAVID",
        "authorized_official_title_or_position": "VP/CFO",
        "authorized_official_telephone_number": "972-789-2816"
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": "FL",
            "license": "987",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "079060500",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kissimmee Primary Care Anti-Aging Wellness and Weight Loss Center PA
• Kissimmee Primary Care Anti-Aging Wellness and Weightloss Center PA
• Kissimmee Primary Care/ Anti-Aging Wellness and Weight Loss Center PA
• Kissimmee SNF LLC (Creekstone Health and Wellness)
• Kissimmee Spine and Rehabilitation Center, LLC
• Kissimmee Urgent Care
• Annelise Kathleen Kistner
• Mallory Robichaux Klein
• Denise L Klemczak, D.O.
• KMBX Solutions LLC

• Ambulatory Surgical Clinic/Center in Kissimmee, FL
• Providers in Kissimmee, FL by specialty
• Ambulatory Surgical Clinic/Center in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 8, 2026; 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.