Active NPI
Surgery Center of Port Charlotte LTD
Doing business as Gulf Pointe Surgery Center
- Ambulatory Surgical Clinic/Center
- Port Charlotte, FL
National Provider Identifier
1679523351
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Ambulatory Surgical Clinic/Center
- Legal business name
- SURGERY CENTER OF PORT CHARLOTTE LTD
- Doing business as
- Gulf Pointe Surgery Center
- Practice address
- 21260 Olean Blvd
Suite 105
Port Charlotte, FL 33952-6705 - Phone
- (941) 235-5800
- Fax
- (941) 235-5801
- NPI assigned
- May 11, 2006
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- David McKnight
- Title
- VP/Cfo
- Phone
- (972) 789-2816
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Ambulatory Surgical Clinic/Center | 261QA1903X | Primary |
Addresses
Primary practice location
21260 Olean Blvd
Suite 105
Port Charlotte, FL 33952-6705
Mailing address
21260 Olean Blvd Ste 105
Port Charlotte, FL 33952-6742
Phone (941) 235-5800
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 076113300 | Medicaid | FL |
Other names 1
- Gulf Pointe Surgery Center
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in FL
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20060913000489 | FL | Part B Supplier - Ambulatory Surgical Center | 2860496460 | Practice locations: Port Charlotte, FL |
Care Compare: Ambulatory surgical center
Medicare Care Compare- Listed as
- Surgery Center of Port Charlotte LTD
- Medicare certification status
- Active
Laboratory certificates & supplier records
Derived by NPIMapThese CMS records do not include an NPI. They are shown because their name and street address match this provider’s.
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 10D1051100 | Gulf Pointe Surgery Center | Certificate of waiver | Feb 21, 2028 |
National Provider Directory
National Provider DirectoryNetworks
- Optimum HealthCare HMO Network
- Freedom Health HMO Network
Practitioners & affiliated clinicians
Practitioners 1
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Surgery Physician
- Two Rivers, WI
- NPI 1114962248
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1147305600000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1788825600000",
"number": "1679523351",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "21260 OLEAN BLVD STE 105",
"city": "PORT CHARLOTTE",
"state": "FL",
"postal_code": "339526742",
"telephone_number": "941-235-5800",
"fax_number": "941-235-5801"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "21260 OLEAN BLVD",
"address_2": "SUITE 105",
"city": "PORT CHARLOTTE",
"state": "FL",
"postal_code": "339526705",
"telephone_number": "941-235-5800",
"fax_number": "941-235-5801"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "SURGERY CENTER OF PORT CHARLOTTE LTD",
"organizational_subpart": "NO",
"enumeration_date": "2006-05-11",
"last_updated": "2026-09-08",
"certification_date": "2026-09-08",
"status": "A",
"authorized_official_last_name": "MCKNIGHT",
"authorized_official_first_name": "DAVID",
"authorized_official_title_or_position": "VP/CFO",
"authorized_official_telephone_number": "972-789-2816"
},
"taxonomies": [
{
"code": "261QA1903X",
"taxonomy_group": "",
"desc": "Clinic/Center, Ambulatory Surgical",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "076113300",
"state": "FL"
}
],
"endpoints": [],
"other_names": [
{
"organization_name": "Gulf Pointe Surgery Center",
"code": "3",
"type": "Doing Business As"
}
]
}
Other providers in Port Charlotte, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 8, 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.