Cottman Ambulatory Surgery Center

Primary specialty

Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X

License

29821500 Issued in PA

Legal business name

COTTMAN AMBULATORY SURGERY CENTER

Doing business as

Wills Surgery Center of the Northeast

Practice address

8400 Roosevelt Blvd
Philadelphia, PA 19152-2012

Phone

(215) 332-7500

Fax

(215) 332-7501

NPI assigned

Oct 26, 2006

Last updated

Apr 14, 2023By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Angela Tuso

Title

Administrator

Phone

(215) 332-7500

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• Wills Surgery Center of the Northeast Doing business as

Listed as

Wills Surgery Center in Northeast PhiladelphiaCCN 39C0001044

Medicare certification status

Terminated Voluntary: merger or closure, Oct 1, 2024From the Provider of Services file

Locations

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.

• Theresa Korneluk Reilly, M.D.

  • Ophthalmology Physician
  • Philadelphia, PA
  • NPI 1700828472
  NPD (past)

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

{
    "created_epoch": "1161820800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1681430400000",
    "number": "1629153770",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8400 ROOSEVELT BLVD",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191522012",
            "telephone_number": "215-332-7500",
            "fax_number": "215-332-7501"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8400 ROOSEVELT BLVD",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191522012",
            "telephone_number": "215-332-7500",
            "fax_number": "215-332-7501"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COTTMAN AMBULATORY SURGERY CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-26",
        "last_updated": "2023-04-14",
        "certification_date": "2023-04-14",
        "status": "A",
        "authorized_official_last_name": "TUSO",
        "authorized_official_first_name": "ANGELA",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "215-332-7500"
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": "PA",
            "license": "29821500",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "490002955",
            "state": "PA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0015764400002",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Wills Surgery Center of the Northeast",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Lisa Cotterall, PT,DPT,CWS
• Natalie Cotteta, CRNP
• Naiga Cottingham, MD
• Cottman & Castor Pain Management
• Cottman 1 Pharmacy LLC (Cottman 1 Pharmacy)
• Cottman Chiropractic Center P.C. (Holme Circle Chiropractic)
• Cottman Medical and Rehabilitation Associates
• Cottman Physician Associates PC
• Kassandra Ivette Cotto
• Jack Cottom, LPC

• Ambulatory Surgical Clinic/Center in Philadelphia, PA
• Providers in Philadelphia, PA by specialty
• Ambulatory Surgical Clinic/Center in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 14, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• 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.