Scottsdale Spine ASC LLC

Primary specialty

Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X

Legal business name

SCOTTSDALE SPINE ASC LLC

Practice address

7242 E Osborn Rd Ste 300
Scottsdale, AZ 85251-6494

Phone

(480) 812-5313

NPI assigned

Nov 2, 2023

Organization subpart

No

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

Authorized official

Name

Jay D McKim

Title

Cfo

Phone

(949) 690-7604

Specialties & licenses 1

Addresses

Other names 1

• Old Town Scottsdale Surgery Center Doing business as

Medicare fee-for-service enrollment

Enrolled in AZ

Enrollment records 1

Listed as

Scottsdale Spine ASC LLC Dba Old Town Scottsdale Surgery CenterCCN 03C0001491

Medicare certification status

ActiveFrom the Provider of Services file

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

CLIA laboratory certificates

Locations

Practitioners 1

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

• William Robert Stevens, M.D.

  • Orthopaedic Surgery of the Spine Physician
  • Phoenix, AZ
  • NPI 1356344824
  NPD (past)

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

{
    "created_epoch": "1698883200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1703721600000",
    "number": "1699548438",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7242 E OSBORN RD STE 300",
            "city": "SCOTTSDALE",
            "state": "AZ",
            "postal_code": "852516494",
            "telephone_number": "480-812-5313"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7242 E OSBORN RD STE 300",
            "city": "SCOTTSDALE",
            "state": "AZ",
            "postal_code": "852516494",
            "telephone_number": "480-812-5313"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SCOTTSDALE SPINE ASC LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-11-02",
        "last_updated": "2023-12-28",
        "certification_date": "2023-12-28",
        "status": "A",
        "authorized_official_last_name": "MCKIM",
        "authorized_official_first_name": "JAY",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "949-690-7604"
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Old Town Scottsdale Surgery Center",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Old Town Scottsdale Surgery Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Scottsdale Skin Boutique Aesthetics
• Scottsdale Skin Boutique and Dermatology PLLC
• Scottsdale Sleep Center PLC
• Scottsdale Sleep Clinic, PLLC
• Scottsdale Smile Center
• Scottsdale Spine Surgery Center, LLC
• Scottsdale Sunshine LLC Dba
• Scottsdale Surgery Center
• Scottsdale Surgery Center One LLC
• Scottsdale Surgical Arts, P.C.

• Ambulatory Surgical Clinic/Center in Scottsdale, AZ
• Providers in Scottsdale, 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 Dec 28, 2023; 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.