Pecan Grove Surgery Center, LLC

Primary specialty

Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X

Legal business name

PECAN GROVE SURGERY CENTER, LLC

Practice address

1111 Sara Swamy Dr Ste B
Sherman, TX 75090-1779

Phone

(903) 893-6311

Fax

(903) 870-0456

NPI assigned

Jun 24, 2024

Organization subpart

No

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

Authorized official

Name

Chirag Mehta, MDNPI 1437471257

Title

Medical Chief of Staff

Phone

(903) 893-6311

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in TX

Enrollment records 1

Ambulatory surgical center certification: CCN 45C0001431

Legal name

PECAN GROVE SURGERY CENTER LLC

Certification status

Active

Provider type (POS)

Ambulatory surgical center

Participating since

Oct 2, 2006

Last certification

Nov 9, 2021

Ownership / control type

Proprietary

Most recent change of ownership

Jul 1, 2024

Facility address

1111 Sara Swamy Drive Suite B
Sherman, TX 75090

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 1

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

• Chirag V Mehta, M.D.

  • Plastic Surgery Physician
  • Richardson, TX
  • NPI 1437471257
  NPD (past) Authorized official

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

{
    "created_epoch": "1719187200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1719187200000",
    "number": "1699519652",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1111 SARA SWAMY DR STE B",
            "city": "SHERMAN",
            "state": "TX",
            "postal_code": "750901779",
            "telephone_number": "903-893-6311"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1111 SARA SWAMY DR STE B",
            "city": "SHERMAN",
            "state": "TX",
            "postal_code": "750901779",
            "telephone_number": "903-893-6311",
            "fax_number": "903-870-0456"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PECAN GROVE SURGERY CENTER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-06-24",
        "last_updated": "2024-06-24",
        "certification_date": "2024-06-24",
        "status": "A",
        "authorized_official_last_name": "MEHTA",
        "authorized_official_first_name": "CHIRAG",
        "authorized_official_title_or_position": "MEDICAL CHIEF OF STAFF",
        "authorized_official_telephone_number": "903-893-6311",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Darci Shae Peach
• Steven Peacock, D.O.
• Peak Physical Therapy & Sports Medicine Center of Sherman
• Peak Physical Therapy, LLC
• Pecan Grove Dental
• Eliza Peckenpaugh
• Pediatric Dental Specialists, PA
• Pediatric Dentistry of Sherman, PA
• Sitien Cu Pedigo
• Mariko Pellum, PTA

• Ambulatory Surgical Clinic/Center in Sherman, TX
• Providers in Sherman, TX by specialty
• Ambulatory Surgical Clinic/Center in Texas

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