Monticello Community Surgery Center, LLC

Primary specialty

Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X

Legal business name

MONTICELLO COMMUNITY SURGERY CENTER, LLC

Doing business as

UVA Health Surgical Care Riverside

Practice address

2331 Seminole Lane
Suite 201
Charlottesville, VA 22901-8319

Phone

(434) 293-4995

Fax

(434) 971-3434

NPI assigned

Mar 2, 2006

Organization subpart

No

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

Authorized official

Name

Jessie Wagner

Title

Administrator

Phone

(434) 971-3406

Specialties & licenses 2

Addresses

Other names 1

• UVA Health Surgical Care Riverside Doing business as

Medicare fee-for-service enrollment

Enrolled in VA

Enrollment records 1

Listed as

Monticello Community Surgery Center LLCCCN 49C0001029

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

Member of 2

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

• Martha Jefferson Hospital

  • Durable Medical Equipment & Medical Supplies
  • Harrisonburg, VA
  • NPI 1326764572

  Member Of

  NPD member
• Rector & Visitors of the University of Virginia

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Staunton, VA
  • NPI 1407212954

  Member Of

  NPD member

Subparts reporting this organization as parent 1

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

• Virginia Retina Consultants, PLC

  • Retina Specialist (Ophthalmology) Physician
  • Charlottesville, VA
  • NPI 1700976834
  NPPES parent name

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

{
    "created_epoch": "1141257600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1685664000000",
    "number": "1629045133",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2331 SEMINOLE LANE",
            "address_2": "SUITE 201",
            "city": "CHARLOTTESVILLE",
            "state": "VA",
            "postal_code": "229018319",
            "telephone_number": "434-293-4995",
            "fax_number": "434-971-3434"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2331 SEMINOLE LANE",
            "address_2": "SUITE 201",
            "city": "CHARLOTTESVILLE",
            "state": "VA",
            "postal_code": "229018319",
            "telephone_number": "434-293-4995",
            "fax_number": "434-971-3434"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MONTICELLO COMMUNITY SURGERY CENTER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-03-02",
        "last_updated": "2023-06-02",
        "certification_date": "2023-06-02",
        "status": "A",
        "authorized_official_last_name": "WAGNER",
        "authorized_official_first_name": "JESSIE",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "434-971-3406"
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": "VA",
            "license": "OH 662",
            "primary": false
        },
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "UVA Health Surgical Care Riverside",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Monroe Health & Rehab Center, LLC
• Margaret Peery Monroe
• Roshni Montana, MD
• Matthew Thomas Montgomery, MD
• Richard M Montgomery, MD
• Monticello Plastic and Reconstructive Surgery, PC
• Gerald Montoya, DNP FNP
• David Tipton Moody, M.D.
• Addison Moon
• Ashley Virginia Moon, MD

• Ambulatory Surgical Clinic/Center in Charlottesville, VA
• Providers in Charlottesville, VA by specialty
• Ambulatory Surgical Clinic/Center in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 2, 2023; 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.