Crater Lake Surgery Center LLC

Primary specialty

Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X

Legal business name

CRATER LAKE SURGERY CENTER LLC

Practice address

833 Bennett Ave
Medford, OR 97504-6715

Phone

(541) 779-5228

NPI assigned

Jan 11, 2016

Last updated

Jun 18, 2018By 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

Dr. Joseph Savino, M.D.NPI 1376535302

Title

Member

Phone

(541) 779-5228

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in OR

Enrollment records 1

Listed as

Crater Lake Surgery Center LLCCCN 38C0001112

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 2

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.

• Karl Robert Freydl, DO

  • Interventional Pain Medicine Physician
  • Novi, MI
  • NPI 1720183353

  OR

  Medicare reassignment NPD
• Joseph Mark Savino, M.D.

  • Pain Medicine (Anesthesiology) Physician
  • Medford, OR
  • NPI 1376535302
  Authorized official Same address or phone

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

{
    "created_epoch": "1452470400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1529280000000",
    "number": "1679939318",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "825 BENNETT AVE",
            "city": "MEDFORD",
            "state": "OR",
            "postal_code": "975046715"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "833 BENNETT AVE",
            "city": "MEDFORD",
            "state": "OR",
            "postal_code": "975046715",
            "telephone_number": "541-779-5228"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "835 Bennett Ave",
            "address_purpose": "LOCATION",
            "city": "Medford",
            "state": "OR",
            "postal_code": "975046715",
            "country_code": "US",
            "telephone_number": "541-779-5228",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "CRATER LAKE SURGERY CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-01-11",
        "last_updated": "2018-06-18",
        "status": "A",
        "authorized_official_last_name": "SAVINO",
        "authorized_official_first_name": "JOSEPH",
        "authorized_official_title_or_position": "MEMBER",
        "authorized_official_telephone_number": "541-779-5228",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kevin Michael Crane, MSW
• Craniosacral Therapy
• Crater Chiropractic Clinic PC
• Crater Lake Acupuncture LLC
• Crater Lake Acupuncture LLC
• Brad Crawford, RN BSN
• Hailey Nicole Crawford, PTA
• Holt Crawford
• Robert Crawford, PSS, CRM
• Sarah L Crawford, NP

• Ambulatory Surgical Clinic/Center in Medford, OR
• Providers in Medford, OR by specialty
• Ambulatory Surgical Clinic/Center in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 18, 2018; 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.