Pediatric Surgery Centers, LLC

Primary specialty

Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X

License

1218 Issued in FL

Legal business name

PEDIATRIC SURGERY CENTERS, LLC

Practice address

10080 Balaye Run Dr
Tampa, FL 33619-7902

Phone

(813) 490-6100

Fax

(813) 490-6105

NPI assigned

Oct 27, 2005

Organization subpart

No

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

Authorized official

Name

Collin Lemaistre

Title

Authorized Official

Phone

(214) 213-0732

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

Ambulatory surgical center certification: CCN 10C0001437

Legal name

PEDIATRIC SURGERY CENTERS

Certification status

Active

Provider type (POS)

Ambulatory surgical center

Participating since

Jan 20, 2005

Last certification

Mar 20, 2019

Ownership / control type

Proprietary

Facility address

10080 Balaye Run Dr
Tampa, FL 33619

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

CLIA laboratory certificates

Member of 2

Organizations this organization is a member of, according to the National Provider Directory.

• Baylor University Medical Center

  • General Acute Care Hospital
  • Dallas, TX
  • NPI 1447250253

  Member Of

  NPD member
• VHS San Antonio Partners LLC

  • Psychiatric Hospital Unit
  • San Antonio, TX
  • NPI 1487633509

  Member Of

  NPD member

Practitioners 1

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

• Nicklas Cary Orobello, M.D.

  • Pediatric Otolaryngology Physician
  • St. Petersburg, FL
  • NPI 1821522830
  NPD (past)

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

{
    "created_epoch": "1130371200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1728950400000",
    "number": "1689664906",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10080 BALAYE RUN DR",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336197902",
            "telephone_number": "813-490-6100",
            "fax_number": "813-490-6105"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10080 BALAYE RUN DR",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336197902",
            "telephone_number": "813-490-6100",
            "fax_number": "813-490-6105"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PEDIATRIC SURGERY CENTERS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-10-27",
        "last_updated": "2024-10-15",
        "certification_date": "2024-10-15",
        "status": "A",
        "authorized_official_last_name": "LEMAISTRE",
        "authorized_official_first_name": "COLLIN",
        "authorized_official_title_or_position": "AUTHORIZED OFFICIAL",
        "authorized_official_telephone_number": "214-213-0732"
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": "FL",
            "license": "1218",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://esmd.abilitynetwork.com:8291/gateway/documentsubmission/2_0/NhinService/XDRRequest_Service",
            "affiliation": "Y",
            "affiliationName": "Ability Network",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "CMS esMD eMDR",
            "address_1": "100 N 6th St Ste 900A",
            "city": "Minneapolis",
            "state": "MN",
            "country_code": "US",
            "postal_code": "554031516",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• Pediatric Physician Services, Inc.
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• Pediatrix Medical Group Florida Inc
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• Pediatrix Medical Group of Florida Inc

• Ambulatory Surgical Clinic/Center in Tampa, FL
• Providers in Tampa, FL by specialty
• Ambulatory Surgical Clinic/Center in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 15, 2024; 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.