Prime Surgical Center of Avondale

Primary specialty

Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X

Legal business name

PRIME SURGICAL CENTER OF AVONDALE

Practice address

10825 W McDowell Rd Ste 120
Avondale, AZ 85392-5014

Phone

(818) 937-9969

NPI assigned

Nov 20, 2023

Organization subpart

No

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

Authorized official

Name

Jessie Timms

Title

VP, Operations

Phone

(916) 213-7874

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in AZ

Enrollment records 1

Ambulatory surgical center certification: CCN 03C0001492

Legal name

Prime Surgical Center of Avondale

Certification status

Active

Provider type (POS)

Ambulatory surgical center

Participating since

Aug 23, 2024

Last certification

Aug 23, 2024

Facility address

10825 West McDowell Road, Suite 120
Avondale, AZ 85392

Locations

Practitioners 1

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

• Matthew Dawson, CRNA

  • Certified Registered Nurse Anesthetist
  • Glendale, AZ
  • NPI 1710763222
  NPD (past)

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

{
    "created_epoch": "1700438400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1788912000000",
    "number": "1689449555",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10825 W MCDOWELL RD STE 120",
            "city": "AVONDALE",
            "state": "AZ",
            "postal_code": "853925107",
            "telephone_number": "623-264-7330"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10825 W MCDOWELL RD STE 120",
            "city": "AVONDALE",
            "state": "AZ",
            "postal_code": "853925014",
            "telephone_number": "818-937-9969"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRIME SURGICAL CENTER OF AVONDALE",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-11-20",
        "last_updated": "2026-09-09",
        "certification_date": "2026-09-09",
        "status": "A",
        "authorized_official_last_name": "TIMMS",
        "authorized_official_first_name": "JESSIE",
        "authorized_official_title_or_position": "VP, OPERATIONS",
        "authorized_official_telephone_number": "916-213-7874"
    },
    "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 Avondale, AZ
• Providers in Avondale, AZ by specialty
• Ambulatory Surgical Clinic/Center in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 9, 2026; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.