Physicians Surgery Center of Tempe, LLC

Primary specialty

Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X

License

OSC0043 Issued in AZ

Legal business name

PHYSICIANS SURGERY CENTER OF TEMPE, LLC

Practice address

1940 E Southern Ave
Tempe, AZ 85282

Phone

(480) 820-7101

Fax

(480) 820-9291

NPI assigned

Aug 11, 2005

Organization subpart

No

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

Authorized official

Name

Eric Boon

Title

Officer, Authorized Official

Phone

(480) 567-0269

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 2

• Arizona Specialty Surgery Center Doing business as
• Physicians Surgery Center of Tempe Doing business as

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in AZ

Enrollment records 1

Listed as

Physicians Surgery Center of Tempe LLC Dba Physicians Surgery Center of TempeCCN 03C0001056

Medicare certification status

ActiveFrom the Provider of Services file

Member of 3

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
• Dignity Health

  • Neurological Surgery Physician
  • Henderson, NV
  • NPI 1720358039

  Member Of

  NPD member
• VHS San Antonio Partners LLC

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

  Member Of

  NPD member

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

{
    "created_epoch": "1123718400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1729728000000",
    "number": "1699777540",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14201 DALLAS PKWY",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752542916",
            "telephone_number": "727-633-8939"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1940 E SOUTHERN AVE",
            "city": "TEMPE",
            "state": "AZ",
            "postal_code": "85282",
            "telephone_number": "480-820-7101",
            "fax_number": "480-820-9291"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2905 W Warner Rd Ste 10",
            "address_purpose": "LOCATION",
            "city": "Chandler",
            "state": "AZ",
            "postal_code": "852241674",
            "country_code": "US",
            "telephone_number": "480-820-7101",
            "fax_number": "480-820-9291",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "PHYSICIANS SURGERY CENTER OF TEMPE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-08-11",
        "last_updated": "2024-10-24",
        "certification_date": "2024-10-24",
        "status": "A",
        "authorized_official_last_name": "BOON",
        "authorized_official_first_name": "ERIC",
        "authorized_official_title_or_position": "OFFICER, AUTHORIZED OFFICIAL",
        "authorized_official_telephone_number": "480-567-0269"
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": "AZ",
            "license": "OSC0043",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "490004403",
            "state": "AZ"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "459801",
            "state": "AZ"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://esmd.abilitynetwork.com:8291/gateway/documentsubmission/2_0/NhinService/XDRRequest_Service",
            "affiliation": "Y",
            "endpointDescription": "2.16.840.1.113883.3.667.2",
            "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": [
        {
            "organization_name": "Arizona Specialty Surgery Center",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Physicians Surgery Center of Tempe",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Physicians Surgery Center of Tempe",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Joseph Gerard Piacentine, MD
• Ann Elizabeth Piedra, LPC

• Ambulatory Surgical Clinic/Center in Tempe, AZ
• Providers in Tempe, 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 Oct 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.
• 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.