Outpatient Surgery Center Inc

Primary specialty

Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X

License

1157 Issued in FL

Legal business name

OUTPATIENT SURGERY CENTER INC

Doing business as

Brandon Outpatient Surgery Center

Practice address

201 Noland Drive
Brandon, FL 33511-5728

Phone

(813) 684-7246

Fax

(302) 688-1113

NPI assigned

Nov 15, 2006

Last updated

Nov 8, 2012By the provider in NPPES

Organization subpart

Yes

Parent organization

OUTPATIENT SURGERY CENTER INCAs reported in NPPES

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

Authorized official

Name

Dr. George S. Sidhom, MDNPI 1003814435

Title

Medical Director

Phone

(813) 731-0416

Specialties & licenses 1

Addresses

Other names 1

• Brandon Outpatient Surgery Center Doing business as

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1619049269. Details of each certification follow.

• CCN 10C0001384 Ambulatory surgical center · Active · Name & address match · Details

Ambulatory surgical center certification: CCN 10C0001384

Legal name

BRANDON OUTPATIENT SURGERY CENTER

Certification status

Active

Provider type (POS)

Ambulatory surgical center

Participating since

Jan 27, 2003

Last certification

Sep 30, 2021

Ownership / control type

Proprietary

Facility address

201 Noland Dr
Brandon, FL 33511

Other NPIs with the same Medicare PAC ID 1

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

• Outpatient Surgery Center, Inc

  dba Mariner Surgery Center

  • Ambulatory Surgical Clinic/Center
  • Spring Hill, FL
  • NPI 1902838402

  5597769141

  Same PAC ID

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

• Outpatient Surgery Center, Inc

  dba Mariner Surgery Center

  • Ambulatory Surgical Clinic/Center
  • Spring Hill, FL
  • NPI 1902838402

  O20060913000135

  Same enrollment

Part of

Outpatient Surgery Center Inc

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.

• George S Sidhom, M.D.

  • Interventional Pain Medicine Physician
  • Spring Hill, FL
  • NPI 1003814435
  NPD Authorized official

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

{
    "created_epoch": "1163548800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1352332800000",
    "number": "1619049269",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 10390",
            "city": "BROOKSVILLE",
            "state": "FL",
            "postal_code": "346030390",
            "telephone_number": "352-688-6393",
            "fax_number": "352-688-1113"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "201 NOLAND DRIVE",
            "city": "BRANDON",
            "state": "FL",
            "postal_code": "335115728",
            "telephone_number": "813-684-7246",
            "fax_number": "302-688-1113"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OUTPATIENT SURGERY CENTER INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "OUTPATIENT SURGERY CENTER INC",
        "enumeration_date": "2006-11-15",
        "last_updated": "2012-11-08",
        "status": "A",
        "authorized_official_last_name": "SIDHOM",
        "authorized_official_first_name": "GEORGE",
        "authorized_official_middle_name": "S.",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "813-731-0416",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": "FL",
            "license": "1157",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Brandon Outpatient Surgery Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Jan Osgood
• Chanelle Osley-Brown
• Ebiuwa Ameze Osula
• Linda Ottl
• Rachel Marie Otto-Thorpe, AU.D.
• Kyleigh Overholt
• Loren Overholt
• Michael Overman, PA-C
• Clarence H Owen, MD
• Ebony Owens

• Ambulatory Surgical Clinic/Center in Brandon, FL
• Providers in Brandon, FL by specialty
• Ambulatory Surgical Clinic/Center in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 8, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.