Organization Active NPI

Specialty Surgical Suites, LLC

  • Ambulatory Surgical Clinic/Center
  • Honolulu, HI
National Provider Identifier
1689013534
Registry record updated Jun 24, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X
Legal business name
SPECIALTY SURGICAL SUITES, LLC
Doing business as
Minimally Invasive Surgery of Hawaii
Practice address
1401 S Beretania St
Suite 600
Honolulu, HI 96814-1870
Phone
(808) 536-2261
Fax
(808) 538-3957
NPI assigned
Jun 24, 2013
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 24, 2013

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

Authorized official

Name
Dr. Gary T Blum, M.D.
Title
Medical Director
Phone
(808) 536-2261

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ambulatory Surgical Clinic/Center 261QA1903X HI Primary

Addresses

Primary practice location

1401 S Beretania St
Suite 600
Honolulu, HI 96814-1870

Mailing address

1401 S Beretania St
Suite 600
Honolulu, HI 96814-1870
Phone (808) 536-2261

Other names 1

  • Minimally Invasive Surgery of Hawaii Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in HI

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20140120000721 HI Part B Supplier - Ambulatory Surgical Center 4688802622 Practice locations: Honolulu, HI

Care Compare: Ambulatory surgical center

Medicare Care Compare
Listed as
Minimally Invasive Surgery HawaiiCCN 12C0001023
Medicare certification status
ActiveFrom the Provider of Services file

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
12D2065941Minimally Invasive Surgery of Hawaii1401 S Beretania St Suite 600, Honolulu, HI 96814Certificate of waiverSep 16, 2027

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1372032000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1372032000000",
    "number": "1689013534",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1401 S BERETANIA ST",
            "address_2": "SUITE 600",
            "city": "HONOLULU",
            "state": "HI",
            "postal_code": "968141870",
            "telephone_number": "808-536-2261",
            "fax_number": "808-538-3957"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1401 S BERETANIA ST",
            "address_2": "SUITE 600",
            "city": "HONOLULU",
            "state": "HI",
            "postal_code": "968141870",
            "telephone_number": "808-536-2261",
            "fax_number": "808-538-3957"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SPECIALTY SURGICAL SUITES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-06-24",
        "last_updated": "2013-06-24",
        "status": "A",
        "authorized_official_last_name": "BLUM",
        "authorized_official_first_name": "GARY",
        "authorized_official_middle_name": "T",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "808-536-2261",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": "HI",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Minimally Invasive Surgery of Hawaii",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Honolulu, HI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 24, 2013; 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.