KS SC LLC

Primary specialty

Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X

Legal business name

KS SC LLC

Doing business as

Kelsey Seybold ASC Bay Area

Practice address

18833 Eastfield Dr
Webster, TX 77598-1305

Phone

(713) 442-4300

NPI assigned

Jan 23, 2024

Last updated

Jan 29, 2024By the provider in NPPES

Organization subpart

Yes

Parent organization

KELSEY-SEYBOLD MEDICAL GROUP, PLLCAs reported in NPPES

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

Authorized official

Name

Julie Burch Garcia

Title

Sr Director, Revenue Cycle MGMT

Phone

(713) 442-5027

Specialties & licenses 1

Addresses

Other names 1

• Kelsey Seybold ASC Bay Area Doing business as

Medicare fee-for-service enrollment

Enrolled in TX

Enrollment records 1

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1700648037. Details of each certification follow.

• CCN 45C0451317 Ambulatory surgical center · Active · Name & address match · Details

Ambulatory surgical center certification: CCN 45C0451317

Legal name

Kelsey Seybold ASC Bay Area

Certification status

Active

Provider type (POS)

Ambulatory surgical center

Participating since

Sep 5, 2025

Last certification

Jul 31, 2025

Ownership / control type

Proprietary

Facility address

18833 Eastfield Drive
Webster, TX 77598

Other NPIs with the same Medicare PAC ID 4

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

• KS SC LLC

  dba Kelsey-Seybold ASC Springwoods Village

  • Ambulatory Surgical Clinic/Center
  • Spring, TX
  • NPI 1124894423

  7214351691

  Same PAC ID
• KS SC LLC

  dba Kelsey Seybold ASC Memorial Villages

  • Ambulatory Surgical Clinic/Center
  • Houston, TX
  • NPI 1144977026

  7214351691

  Same PAC ID
• KS SC LLC

  dba Kelsey-Seybold Clinic Ambulatory Surgery Center

  • Ambulatory Surgical Clinic/Center
  • Houston, TX
  • NPI 1699327734

  7214351691

  Same PAC ID
• KS SC LLC

  dba Kelsey Seybold ASC Fort Bend

  • Ambulatory Surgical Clinic/Center
  • Sugar Land, TX
  • NPI 1720840390

  7214351691

  Same PAC ID

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

CLIA laboratory certificates

Tax ID family

KS SC LLC5 organizations share this tax ID, including this one

Part of

Rachna a Jafri

Other organizations with this tax ID 4

Organizations that report the same tax identification number in the National Provider Directory.

• KS SC LLC

  dba Kelsey-Seybold ASC Springwoods Village

  • Ambulatory Surgical Clinic/Center
  • Spring, TX
  • NPI 1124894423
  NPD tax ID
• KS SC LLC

  dba Kelsey Seybold ASC Memorial Villages

  • Ambulatory Surgical Clinic/Center
  • Houston, TX
  • NPI 1144977026
  NPD tax ID
• KS SC LLC

  dba Kelsey-Seybold Clinic Ambulatory Surgery Center

  • Ambulatory Surgical Clinic/Center
  • Houston, TX
  • NPI 1699327734
  NPD tax ID
• KS SC LLC

  dba Kelsey Seybold ASC Fort Bend

  • Ambulatory Surgical Clinic/Center
  • Sugar Land, TX
  • NPI 1720840390
  NPD tax ID

Locations

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

• Kelsey-Seybold Medical Group, PLLC

  dba Kelsey Seybold Clinic

  • Multi-Specialty Clinic/Center
  • Houston, TX
  • NPI 1013915255
  NPPES parent name

Practitioners 25

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Nour Batarseh, MD

  • Endocrinology, Diabetes & Metabolism Physician
  • Webster, TX
  • NPI 1184023384
  NPD
• Asmeen Bhatt, M.D.

  • Gastroenterology Physician
  • Houston, TX
  • NPI 1770784399
  NPD
• Horace Anthony Brown Jr., MD

  • Sports Medicine (Family Medicine) Physician
  • Webster, TX
  • NPI 1972065126
  NPD
• Courtney Champagne, FNP-C

  • Family Nurse Practitioner
  • Webster, TX
  • NPI 1043928229
  NPD
• Marines Paredes Chapman, APRN, FNP-C

  • Primary Care Nurse Practitioner
  • League City, TX
  • NPI 1548098155
  NPD
• Eric Lowry Cole, MD

  • Plastic Surgery Physician
  • Galveston, TX
  • NPI 1295786960
  NPD
• Lamia Derzi, MD

  • Obstetrics & Gynecology Physician
  • Webster, TX
  • NPI 1164047403
  NPD
• Rohit Vivek Goswamy, MD

  • Hematology & Oncology Physician
  • Houston, TX
  • NPI 1396235669
  NPD
• Hannah Marie Hester, PA-C

  • Physician Assistant
  • Webster, TX
  • NPI 1346063807
  NPD
• Alan Hsieh, MD

  • Urology Physician
  • Webster, TX
  • NPI 1508360736
  NPD
• Nicole Hunt, MBBS, MD

  • Rheumatology Physician
  • Webster, TX
  • NPI 1750776134
  NPD
• Nadia Jamil, MD

  • Endocrinology, Diabetes & Metabolism Physician
  • Webster, TX
  • NPI 1861926651
  NPD

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

{
    "created_epoch": "1705968000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1706486400000",
    "number": "1700648037",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11511 SHADOW CREEK PKWY",
            "address_2": "CENTRAL BUSINESS OFFICE (ASC)",
            "city": "PEARLAND",
            "state": "TX",
            "postal_code": "775847298",
            "telephone_number": "713-442-5669"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18833 EASTFIELD DR",
            "city": "WEBSTER",
            "state": "TX",
            "postal_code": "775981305",
            "telephone_number": "713-442-4300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KS SC LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "KELSEY-SEYBOLD MEDICAL GROUP, PLLC",
        "enumeration_date": "2024-01-23",
        "last_updated": "2024-01-29",
        "certification_date": "2024-01-29",
        "status": "A",
        "authorized_official_last_name": "GARCIA",
        "authorized_official_first_name": "JULIE",
        "authorized_official_middle_name": "BURCH",
        "authorized_official_title_or_position": "SR DIRECTOR, REVENUE CYCLE MGMT",
        "authorized_official_telephone_number": "713-442-5027"
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Kelsey Seybold ASC Bay Area",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Erwin Korman, MD
• Smita Kotecha, RPH
• Krista Koch Tejml, MD PA
• Ryan Joseph Kristynik, PTA
• KS Pharm LLC (Kelsey Pharmacy)
• Jodi Renee Kuehn, FNP-C
• Mohan S Kumar, M.D.
• Santhosh Bhaskar Kumar, MD
• L. Mauricio Rodriguez DDS, PA (Premier Dental)
• Mykaela Aleya La Fuente, BS, BCABA

• Ambulatory Surgical Clinic/Center in Webster, TX
• Providers in Webster, 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 Jan 29, 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.