Michigan Institute for Advanced Surgery Center, LLC

Primary specialty

Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X

License

1010000067 Issued in MI

Legal business name

MICHIGAN INSTITUTE FOR ADVANCED SURGERY CENTER, LLC

Practice address

1375 S Lapeer Road
Suite 109
Lake Orion, MI 48360

Phone

(248) 693-7950

Fax

(248) 693-2658

NPI assigned

Sep 24, 2006

Organization subpart

No

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

Authorized official

Name

Claire Gibson

Title

Sr Vpo

Phone

(214) 726-6042

Specialties & licenses 1

Addresses

Other names 1

• Michigan Institute for Advanced Surgery Center Doing business as

Medicare fee-for-service enrollment

Enrolled in MI

Enrollment records 1

Listed as

Bald Mountain Surgical CenterCCN 23C0001083

Medicare certification status

ActiveFrom the Provider of Services file

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

CLIA laboratory certificates

Practitioners 2

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

• Jeffrey H Declaire, M.D.

  • Adult Reconstructive Orthopaedic Surgery Physician
  • Rochester, MI
  • NPI 1265442446
  NPD
• Mykola John Bartkiw, D.O.

  • Orthopaedic Surgery Physician
  • Auburn Hills, MI
  • NPI 1861619736
  NPD (past)

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

{
    "created_epoch": "1159056000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1778025600000",
    "number": "1619077211",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1375 S LAPEER RD STE 109",
            "city": "LAKE ORION",
            "state": "MI",
            "postal_code": "483601421",
            "telephone_number": "248-693-7950",
            "fax_number": "248-693-2658"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1375 S LAPEER ROAD",
            "address_2": "SUITE 109",
            "city": "LAKE ORION",
            "state": "MI",
            "postal_code": "48360",
            "telephone_number": "248-693-7950",
            "fax_number": "248-693-2658"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MICHIGAN INSTITUTE FOR ADVANCED SURGERY CENTER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-24",
        "last_updated": "2026-05-06",
        "certification_date": "2026-05-06",
        "status": "A",
        "authorized_official_last_name": "GIBSON",
        "authorized_official_first_name": "CLAIRE",
        "authorized_official_title_or_position": "SR VPO",
        "authorized_official_telephone_number": "214-726-6042"
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": "MI",
            "license": "1010000067",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Michigan Institute for Advanced Surgery Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Tina M Meyer, PH.D.
• Mi Awareness PLLC
• Michigan Bone and Joint Center
• Michigan Gulf to Bay Anesthesiology Associates PSC
• Michigan Hearing, LLC
• Michigan Institute for Interventional Pain PLLC
• Michigan Rehabilitation Specialists of Fowlerville, LLC
• Migun S B G Services LLC
• Mariana Milan
• Millage Family Chiropractic

• Ambulatory Surgical Clinic/Center in Lake Orion, MI
• Providers in Lake Orion, MI by specialty
• Ambulatory Surgical Clinic/Center in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 6, 2026; 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.