Centre Avenue Group, LLC

Primary specialty

Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X

Legal business name

CENTRE AVENUE GROUP, LLC

Doing business as

East Side Surgery Center

Practice address

5800 Centre Ave
Pittsburgh, PA 15206-3710

Phone

(412) 661-5500

NPI assigned

Feb 28, 2007

Last updated

Aug 22, 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

Christopher Kolic, CPA,, ESQ

Title

Ceo,

Phone

(412) 661-5500

Specialties & licenses 1

Addresses

Other names 1

• East Side Surgery Center Doing business as

Medicare fee-for-service enrollment

Enrolled in PA

Enrollment records 1

Listed as

East Side Surgery CenterCCN 39C0001248

Medicare certification status

ActiveFrom 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.

• Anthony D Watson, MD

  • Specialist
  • Brackenridge, PA
  • NPI 1568454007
  NPD (past)

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

{
    "created_epoch": "1172620800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1659408300",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5800 CENTRE AVE",
            "city": "PITTSBURGH",
            "state": "PA",
            "postal_code": "152063710",
            "telephone_number": "412-661-5500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5800 CENTRE AVE",
            "city": "PITTSBURGH",
            "state": "PA",
            "postal_code": "152063710",
            "telephone_number": "412-661-5500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CENTRE AVENUE GROUP, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-28",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "KOLIC",
        "authorized_official_first_name": "CHRISTOPHER",
        "authorized_official_title_or_position": "CEO,",
        "authorized_official_telephone_number": "412-661-5500",
        "authorized_official_credential": "CPA,, ESQ"
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "East Side Surgery Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Central Cardiovascular Associates, P.C. (SouthWestern Pennsylvania Cardiovascular Associates)
• Central Optique, Inc (dalmo optical)
• Central Outreach Resource and Referral Center
• Central Outreach Wellness Center
• Central Pittsburgh Psychiatric Services
• Ronald William Cepek
• Regan D. Ceraso, RPH
• Connor Thomas Cerato, DO
• Angelica Cercone
• Russell Mitesh Cerejo, M.D.

• Ambulatory Surgical Clinic/Center in Pittsburgh, PA
• Providers in Pittsburgh, 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 Aug 22, 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.