The Surgery Center of the Villages, LLC

Primary specialty

Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X

Legal business name

THE SURGERY CENTER OF THE VILLAGES, LLC

Doing business as

The Surgery Center of the Villages

Practice address

17560 SE 109TH Terrace Rd
Summerfield, FL 34491-6907

Phone

(352) 735-2020

Fax

(352) 347-1421

NPI assigned

Aug 28, 2007

Last updated

Feb 5, 2020By 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

George L Neal

Title

President

Phone

(469) 214-0144

Specialties & licenses 1

Addresses

Other names 1

• The Surgery Center of the Villages Doing business as

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

Listed as

The Surgery Center of the Villages LLCCCN 10C0001514

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 organizations 1

Organizations listed as members of this organization in the National Provider Directory.

• Central Florida Anesthesia Solutions LLC

  • Anesthesiology Physician
  • Mount Dora, FL
  • NPI 1073816401

  Member Of

  NPD member

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.

• Kacey A Montgomery, MD

  • Pain Medicine (Anesthesiology) Physician
  • Pensacola, FL
  • NPI 1447455977
  Medicare reassignment NPD

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

{
    "created_epoch": "1188259200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1580860800000",
    "number": "1629262274",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17560 SE 109TH TERRACE RD",
            "city": "SUMMERFIELD",
            "state": "FL",
            "postal_code": "344916907",
            "telephone_number": "352-735-2020",
            "fax_number": "352-347-1421"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17560 SE 109TH TERRACE RD",
            "city": "SUMMERFIELD",
            "state": "FL",
            "postal_code": "344916907",
            "telephone_number": "352-735-2020",
            "fax_number": "352-347-1421"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE SURGERY CENTER OF THE VILLAGES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-08-28",
        "last_updated": "2020-02-05",
        "certification_date": "2020-02-05",
        "status": "A",
        "authorized_official_last_name": "NEAL",
        "authorized_official_first_name": "GEORGE",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "469-214-0144"
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "The Surgery Center of the Villages",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "The Surgery Center of the Villages",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Timothy John Van de Leur, MD

• Ambulatory Surgical Clinic/Center in Summerfield, FL
• Providers in Summerfield, 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 Feb 5, 2020; 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.