NPIMap

Organization Active NPI

Specialty Surgery Center of Pecos, LLC

Doing business as Outpatient Surgical Center of Flamingo

  • Ambulatory Surgical Clinic/Center
  • Las Vegas, NV
National Provider Identifier
1598902199
Registry record updated May 7, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X
Legal business name
SPECIALTY SURGERY CENTER OF PECOS, LLC
Doing business as
Outpatient Surgical Center of Flamingo
Practice address
1569 E Flamingo Rd
Las Vegas, NV 89119-5277
Phone
(702) 370-7149
NPI assigned
Jan 19, 2009
Last updated
May 7, 2009By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 7, 2009

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

Authorized official

Name
Craig Foreman, D.C., R.N.
Title
Administrator
Phone
(702) 370-7149

Specialties & licenses 1

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

Addresses

Primary practice location

1569 E Flamingo Rd
Las Vegas, NV 89119-5277

Mailing address

1569 E Flamingo Rd
Las Vegas, NV 89119-5277
Phone (702) 370-7149

Other names 1

  • Outpatient Surgical Center of Flamingo Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1598902199. Details of each certification follow.

Ambulatory surgical center certification: CCN 29C0001101

Name & address match This certification has no NPI in the Medicare enrollment files. CMS publishes enrollment files for six facility types only, so it was connected to this NPI by matching the name and address CMS publishes for it.

Legal name
OUTPATIENT SURGICAL CENTER OF FLAMINGO
Certification status
Active
Provider type (POS)
Ambulatory surgical center
Participating since
Jan 11, 2012
Last certification
Jan 11, 2012
Ownership / control type
Proprietary
Facility address
1569 E Flamingo Rd
Las Vegas, NV 89119

National Provider Directory

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, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1232323200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1241654400000",
    "number": "1598902199",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1569 E FLAMINGO RD",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891195277",
            "telephone_number": "702-370-7149"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1569 E FLAMINGO RD",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891195277",
            "telephone_number": "702-370-7149"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SPECIALTY SURGERY CENTER OF PECOS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-01-19",
        "last_updated": "2009-05-07",
        "status": "A",
        "authorized_official_last_name": "FOREMAN",
        "authorized_official_first_name": "CRAIG",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "702-370-7149",
        "authorized_official_credential": "D.C., R.N."
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Outpatient Surgical Center of Flamingo",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Las Vegas, NV

Sources for this page

Verify at the official NPI Registry.