Mao Leawood Surgery Center LLC

Primary specialty

Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X

Legal business name

MAO LEAWOOD SURGERY CENTER LLC

Practice address

4940 W 137TH Street
Leawood, KS 66224

Phone

(316) 866-2540

NPI assigned

Feb 2, 2018

Last updated

Feb 2, 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

Mary Chau-Nguyen

Title

Management

Phone

(316) 300-6515

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in KS

Enrollment records 1

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1689173981. Details of each certification follow.

• CCN 170207 Hospital · Terminated · Name & address match · Details

Hospital certification: CCN 170207

Legal name

MAO LEAWOOD SURGERY CENTER, LLC

Certification status

Terminated Voluntary: merger or closure, May 11, 2023

Provider type (POS)

Hospital – Short-term

Participating since

May 10, 2021

Last certification

May 10, 2021

Beds

1

Ownership / control type

Private (for profit)

Facility address

4940 West 137TH Street, Suite a
Leawood, KS 66224

Listed as

Mao Leawood Surgery Center LLCCCN 17C0001101

Medicare certification status

ActiveFrom the Provider of Services file

Locations

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.

• Michael J Dempewolf, D.O.

  • Sports Medicine (Orthopaedic Surgery) Physician
  • Leawood, KS
  • NPI 1558654392
  NPD
• Pat Dinh DO, MD

  • Orthopaedic Surgery Physician
  • Wichita, KS
  • NPI 1013994979
  NPD

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

{
    "created_epoch": "1517529600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1517529600000",
    "number": "1689173981",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1923 N WEBB RD",
            "city": "WICHITA",
            "state": "KS",
            "postal_code": "672063405",
            "telephone_number": "316-300-6515"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4940 W 137TH STREET",
            "city": "LEAWOOD",
            "state": "KS",
            "postal_code": "66224",
            "telephone_number": "316-866-2540"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MAO LEAWOOD SURGERY CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-02-02",
        "last_updated": "2018-02-02",
        "status": "A",
        "authorized_official_last_name": "CHAU-NGUYEN",
        "authorized_official_first_name": "MARY",
        "authorized_official_title_or_position": "MANAGEMENT",
        "authorized_official_telephone_number": "316-300-6515"
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Ambulatory Surgical Clinic/Center in Leawood, KS
• Providers in Leawood, KS by specialty
• Ambulatory Surgical Clinic/Center in Kansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 2, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
• 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.