Keystone Surgery Center, LTD

Primary specialty

Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X

License

16671501 Issued in PA

Legal business name

KEYSTONE SURGERY CENTER, LTD

Practice address

575 E Norwegian St
Pottsville, PA 17901-3711

Phone

(570) 622-1200

Fax

(570) 622-7787

NPI assigned

Jan 31, 2006

Organization subpart

No

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

Authorized official

Name

Dr. Robert Monroe Kimmel, M.D., FACSNPI 1205808631

Title

Ceo/Medical Director

Phone

(570) 622-1200

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in PA

Enrollment records 1

Listed as

Keystone Surgery Center LTDCCN 39C0001146

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

Practitioners 1

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

• Robert Monroe Kimmel, M.D., FACS

  • Plastic and Reconstructive Surgery Physician
  • Pottsville, PA
  • NPI 1205808631
  NPD Authorized official

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

{
    "created_epoch": "1138665600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1232582400000",
    "number": "1679544290",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "575 E NORWEGIAN ST",
            "city": "POTTSVILLE",
            "state": "PA",
            "postal_code": "179013711",
            "telephone_number": "570-622-1200",
            "fax_number": "570-622-7787"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "575 E NORWEGIAN ST",
            "city": "POTTSVILLE",
            "state": "PA",
            "postal_code": "179013711",
            "telephone_number": "570-622-1200",
            "fax_number": "570-622-7787"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KEYSTONE SURGERY CENTER, LTD",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-01-31",
        "last_updated": "2009-01-22",
        "status": "A",
        "authorized_official_last_name": "KIMMEL",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "MONROE",
        "authorized_official_title_or_position": "CEO/MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "570-622-1200",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D., FACS"
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": "PA",
            "license": "16671501",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Margaret Keifer
• Samantha Rose Keifer, PT, DPT
• Aurora Danielle Kellmer
• William T Kellogg, MD
• Cassandra Kessock, DO
• Mahnoor Aitzaz Khan, MD
• Ayman Mohsen Khanafer
• Abdelmohsen Kholoussy, MD
• Kidspeace National Center, Inc
• Caitlin Kimmel

• Ambulatory Surgical Clinic/Center in Pottsville, PA
• Providers in Pottsville, 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 Jan 22, 2009; 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.