Chesterton Surgery Center LLC
Organization Active NPI Ambulatory Surgical Clinic/Center · Chesterton, IN
NPI 1548629181 · NPPES record last updated Aug 21, 2024
Key facts
- NPI
- 1548629181
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Ambulatory Surgical Clinic/Center 261QA1903X
- Legal business name
- CHESTERTON SURGERY CENTER LLC
- Practice address
- 3111 Village PT
Chesterton, IN 46304-9689 - Phone
- (219) 983-1401
- Fax
- (219) 929-1408
- NPI assigned
- Feb 10, 2016
- Organization subpart
- No
Authorized official
- Name
- Kristy Music
- Title
- Ao-Director Provider Enrollment
- Phone
- (615) 465-7377
Member of 2
Medicare Care Compare: Ambulatory surgical center
- Listed as
- Chesterton Surgery Center LLC
- Medicare certification status
- Active
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in IN
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20160411000382 | IN | Part B Supplier - Ambulatory Surgical Center | 8921306853 | Practice locations: Chesterton, IN |
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Ambulatory Surgical Clinic/Center | 261QA1903X | Yes |
Addresses
Primary practice location
3111 Village PT
Chesterton, IN 46304-9689
Mailing address
3111 Village PT
Chesterton, IN 46304-9689
Phone (219) 983-1401
Other names
- Northwest Health Lakeshore Surgicare
Other providers in Chesterton, IN
- Kimberly Elizabeth Chambers
- Cynthia Lynn Cheek
- Chesterton Family Dental
- Chesterton Physical Therapy, Inc.
- Chesterton Smiles Inc
- Jamie Chin-Theodorou
- Laura Lynn Cipowski
- Lindsey M Cirak
- Briana Clark
- Ashley Cline
All providers in Chesterton, IN · Ambulatory Surgical Clinic/Center in Indiana
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 21, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.