West Bloomfield Surgery Center, LLC

Primary specialty

Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X

License

63-6923 Issued in MI

Legal business name

WEST BLOOMFIELD SURGERY CENTER, LLC

Doing business as

Lakes Surgery Center

Practice address

2300 Haggerty Rd
Suite 1000
West Bloomfield, MI 48323-2184

Phone

(248) 896-6300

Fax

(248) 896-6321

NPI assigned

May 17, 2006

Organization subpart

No

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

Authorized official

Name

Jennifer Boyd Baldock

Title

Officer and Authorized Official

Phone

(615) 234-5954

Specialties & licenses 1

Addresses

Other names 1

• Lakes Surgery Center Doing business as

Medicare fee-for-service enrollment

Enrolled in MI

Enrollment records 1

Listed as

West Bloomfield Surgery Center LLC Dba Lakes Surgery CenterCCN 23C0001061

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

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Steven Joe Kin, D.O.

  • Otolaryngic Allergy Physician
  • West Bloomfield, MI
  • NPI 1427037282
  NPD (past)

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

{
    "created_epoch": "1147824000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1704326400000",
    "number": "1679526297",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2300 HAGGERTY RD",
            "address_2": "SUITE 1000",
            "city": "WEST BLOOMFIELD",
            "state": "MI",
            "postal_code": "483232184",
            "telephone_number": "248-896-6300",
            "fax_number": "248-896-6321"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2300 HAGGERTY RD",
            "address_2": "SUITE 1000",
            "city": "WEST BLOOMFIELD",
            "state": "MI",
            "postal_code": "483232184",
            "telephone_number": "248-896-6300",
            "fax_number": "248-896-6321"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WEST BLOOMFIELD SURGERY CENTER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-17",
        "last_updated": "2024-01-04",
        "certification_date": "2024-01-04",
        "status": "A",
        "authorized_official_last_name": "BALDOCK",
        "authorized_official_first_name": "JENNIFER",
        "authorized_official_middle_name": "BOYD",
        "authorized_official_title_or_position": "OFFICER AND AUTHORIZED OFFICIAL",
        "authorized_official_telephone_number": "615-234-5954"
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": "MI",
            "license": "63-6923",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Lakes Surgery Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• West Bloomfield Opco LLC (Medilodge of West Bloomfield)
• West Bloomfield Physical Therapy , Inc
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• West Bloomfield Psychiatric Services PLLC
• West Bloomfield SNF LLC (Illuminate HC West Bloomfield)
• West Broomfield Dialysis LLC (West Bloomfield Dialysis)
• West Maple Plastic Surgery PLLC
• West Oaks Dental Group
• West Oaks Dental Group, P.C.
• Rachel West

• Ambulatory Surgical Clinic/Center in West Bloomfield, MI
• Providers in West Bloomfield, MI by specialty
• Ambulatory Surgical Clinic/Center in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 4, 2024; 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.