NPIMap

Organization Active NPI

Surgery Center of Scottsdale, LLC

  • Ambulatory Surgical Clinic/Center
  • Gilbert, AZ
National Provider Identifier
1558794081
Registry record updated Jan 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X
License
OSC6367 Issued in AZ
Legal business name
SURGERY CENTER OF SCOTTSDALE, LLC
Practice address
2450 E Guadalupe Rd
Ste 101
Gilbert, AZ 85234-5116
Phone
(480) 398-8456
Fax
(480) 584-3063
NPI assigned
Aug 20, 2013
Last updated
Jan 11, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 11, 2025

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

Authorized official

Name
Eric Boon
Title
Officer/Authorized Official
Phone
(480) 567-0269

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ambulatory Surgical Clinic/Center 261QA1903X OSC6367 AZ Primary

Addresses

Primary practice location

2450 E Guadalupe Rd
Ste 101
Gilbert, AZ 85234-5116

Mailing address

2450 E Guadalupe Rd
Ste 101
Gilbert, AZ 85234-5116
Phone (480) 228-3757

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL https://esmd.abilitynetwork.com:8291/gateway/documentsubmission/2_0/NhinService/XDRRequest_Service Other Ability Network

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20170510001014 AZ Part B Supplier - Ambulatory Surgical Center 9032121025 Practice locations: Gilbert, AZ

Other NPIs with the same Medicare PAC ID 2

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Care Compare: Ambulatory surgical center

Medicare Care Compare
Listed as
Surgery Center of Scottsdale LLC Dba Mountain View Surgery Center of GilbertCCN 03C0001045
Medicare certification status
Terminated Voluntary: merger or closure, Oct 31, 2018From the Provider of Services file

Care Compare: Ambulatory surgical center

Medicare Care Compare
Listed as
Surgery Center of Scottsdale LLC Dba Mountain View Surgery Center of GilbertCCN 03C0001357
Medicare certification status
ActiveFrom the Provider of Services file

National Provider Directory

National Provider Directory
Tax ID family
Ability Network3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

Member of 3

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

NPI Registry JSON

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

{
    "created_epoch": "1376956800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1736553600000",
    "number": "1558794081",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2450 E GUADALUPE RD",
            "address_2": "STE 101",
            "city": "GILBERT",
            "state": "AZ",
            "postal_code": "852345116",
            "telephone_number": "480-228-3757",
            "fax_number": "480-907-2741"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2450 E GUADALUPE RD",
            "address_2": "STE 101",
            "city": "GILBERT",
            "state": "AZ",
            "postal_code": "852345116",
            "telephone_number": "480-398-8456",
            "fax_number": "480-584-3063"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SURGERY CENTER OF SCOTTSDALE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-08-20",
        "last_updated": "2025-01-11",
        "certification_date": "2025-01-11",
        "status": "A",
        "authorized_official_last_name": "BOON",
        "authorized_official_first_name": "ERIC",
        "authorized_official_title_or_position": "OFFICER/AUTHORIZED OFFICIAL",
        "authorized_official_telephone_number": "480-567-0269"
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": "AZ",
            "license": "OSC6367",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://esmd.abilitynetwork.com:8291/gateway/documentsubmission/2_0/NhinService/XDRRequest_Service",
            "affiliation": "Y",
            "endpointDescription": "2.16.840.1.113883.3.667.2",
            "affiliationName": "Ability Network",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "CMS esMD eMDR",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "64 S Price Rd Ste B",
            "city": "Brownsville",
            "state": "TX",
            "country_code": "US",
            "postal_code": "785212459",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Gilbert, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 11, 2025; 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.