Organization Active NPI

Memorial Hermann Surgery Center Memorial City LLC

  • Ambulatory Surgical Clinic/Center
  • Houston, TX
National Provider Identifier
1598096802
Registry record updated Oct 11, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X
License
130143 Issued in TX
Legal business name
MEMORIAL HERMANN SURGERY CENTER MEMORIAL CITY LLC
Practice address
1120 Business Center Dr
Ste 110
Houston, TX 77043-2735
Phone
(713) 337-1111
Fax
(713) 337-1112
NPI assigned
Jan 26, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 11, 2024

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

Authorized official

Name
Nicholas Crafts
Title
Officer/Authorized Official
Phone
(832) 729-4009

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ambulatory Surgical Clinic/Center 261QA1903X 130143 TX Primary

Addresses

Primary practice location

1120 Business Center Dr
Ste 110
Houston, TX 77043-2735

Mailing address

1120 Business Center Dr
Ste 110
Houston, TX 77043-2735
Phone (713) 337-1111

Other names 1

  • Memorial Hermann Memorial Village Surgery Center Doing business as

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 TX

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20100427000558 TX Part B Supplier - Ambulatory Surgical Center 0840327607 Practice locations: Houston, TX

Care Compare: Ambulatory surgical center

Medicare Care Compare
Listed as
Memorial Hermann Memorial Village Surgery CenterCCN 45C0001513
Medicare certification status
ActiveFrom the Provider of Services file

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
45D0919771Memorial Hermann Memorial Village1120 Business Center Drive, Ste 110, Houston, TX 77043Certificate of waiverSep 15, 2026
45D2268397Memorial Hermann Village1120 Business Center Dr, Suite 300, Houston, TX 77043Certificate of waiverSep 8, 2026

National Provider Directory

National Provider Directory

Member of 2

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

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1264464000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1728604800000",
    "number": "1598096802",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1120 BUSINESS CENTER DR",
            "address_2": "STE 110",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770432735",
            "telephone_number": "713-337-1111",
            "fax_number": "713-337-1112"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1120 BUSINESS CENTER DR",
            "address_2": "STE 110",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770432735",
            "telephone_number": "713-337-1111",
            "fax_number": "713-337-1112"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEMORIAL HERMANN SURGERY CENTER MEMORIAL CITY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-01-26",
        "last_updated": "2024-10-11",
        "certification_date": "2024-10-11",
        "status": "A",
        "authorized_official_last_name": "CRAFTS",
        "authorized_official_first_name": "NICHOLAS",
        "authorized_official_title_or_position": "OFFICER/AUTHORIZED OFFICIAL",
        "authorized_official_telephone_number": "832-729-4009"
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": "TX",
            "license": "130143",
            "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",
            "address_1": "100 N 6th St Ste 900A",
            "city": "Minneapolis",
            "state": "MN",
            "country_code": "US",
            "postal_code": "554031516",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Memorial Hermann Memorial Village Surgery Center",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Memorial Hermann Memorial Village Surgery Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Houston, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 11, 2024; 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.