Ideal Surgical Center, LLC

Primary specialty

Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X

Legal business name

IDEAL SURGICAL CENTER, LLC

Doing business as

Ideal Surgical Center, LLC

Practice address

6424 E Broadway Rd Ste 102
Mesa, AZ 85206-1750

Phone

(480) 634-4606

NPI assigned

Nov 19, 2019

Last updated

Nov 19, 2019By 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

Brandie Hernandez

Title

Director of Operations

Phone

(480) 634-4606

Specialties & licenses 1

Addresses

Other names 1

• Ideal Surgical Center, LLC Doing business as

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

{
    "created_epoch": "1574121600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1574121600000",
    "number": "1568008167",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6424 E BROADWAY RD STE 102",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852061750",
            "telephone_number": "480-634-4606"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6424 E BROADWAY RD STE 102",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852061750",
            "telephone_number": "480-634-4606"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "IDEAL SURGICAL CENTER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-11-19",
        "last_updated": "2019-11-19",
        "status": "A",
        "authorized_official_last_name": "HERNANDEZ",
        "authorized_official_first_name": "BRANDIE",
        "authorized_official_title_or_position": "DIRECTOR OF OPERATIONS",
        "authorized_official_telephone_number": "480-634-4606"
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Ideal Surgical Center, LLC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Icare Home Health Services LLC
• Wanda G Ichiriu, PA
• Icu423R
• Serena Ide Noumy
• Ideal Rehabilitation PLLC
• Aya Shion Ienaga, PA-C
• Brian J. Igel, M.D.
• Yuliya Ignatyeva
• Dorothy Igwe
• Ilitchi Home Care LLC

• Ambulatory Surgical Clinic/Center in Mesa, AZ
• Providers in Mesa, AZ by specialty
• Ambulatory Surgical Clinic/Center in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 19, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.