Surgery Center of Wasilla, LLC

Primary specialty

Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X

License

976033 Issued in AK

Legal business name

SURGERY CENTER OF WASILLA, LLC

Practice address

3190 E Meridian Park Loop Ste 111
Wasilla, AK 99654-7422

Phone

(907) 631-3578

Fax

(907) 782-4561

NPI assigned

Jul 2, 2012

Organization subpart

No

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

Authorized official

Name

Riley Orr

Title

Coo

Phone

(615) 314-1406

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in AK

Enrollment records 1

Listed as

Surgery Center of Wasilla LLCCCN 02C0001015

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

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

{
    "created_epoch": "1341187200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1778025600000",
    "number": "1649534843",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3190 E MERIDIAN PARK LOOP STE 111",
            "city": "WASILLA",
            "state": "AK",
            "postal_code": "996547422",
            "telephone_number": "907-631-3578",
            "fax_number": "907-782-4561"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3190 E MERIDIAN PARK LOOP STE 111",
            "city": "WASILLA",
            "state": "AK",
            "postal_code": "996547422",
            "telephone_number": "907-631-3578",
            "fax_number": "907-782-4561"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SURGERY CENTER OF WASILLA, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-07-02",
        "last_updated": "2026-05-06",
        "certification_date": "2026-05-06",
        "status": "A",
        "authorized_official_last_name": "ORR",
        "authorized_official_first_name": "RILEY",
        "authorized_official_title_or_position": "COO",
        "authorized_official_telephone_number": "615-314-1406"
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": "AK",
            "license": "976033",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Ambulatory Surgical Clinic/Center in Wasilla, AK
• Providers in Wasilla, AK by specialty
• Ambulatory Surgical Clinic/Center in Alaska

• 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.