Active NPI
Pacific Surgery Center, LLC
- Ambulatory Surgical Clinic/Center
- Omaha, NE
National Provider Identifier
1720334097
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Ambulatory Surgical Clinic/Center
- Legal business name
- PACIFIC SURGERY CENTER, LLC
- Practice address
- 10707 Pacific St Ste 100
Omaha, NE 68114-4762 - Phone
- (402) 933-1844
- Fax
- (402) 932-5891
- NPI assigned
- Jul 24, 2012
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Dr. Euclid Desouza
- Title
- Board Member
- Phone
- (402) 391-2166
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Ambulatory Surgical Clinic/Center | 261QA1903X | Primary |
Addresses
Primary practice location
10707 Pacific St Ste 100
Omaha, NE 68114-4762
Mailing address
6128 S Lyncrest Ave
Sioux Falls, SD 57108-2560
Phone (855) 334-2955
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| NA2347 | Other | NE | PTAN |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NE
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20130129000115 | NE | Part B Supplier - Ambulatory Surgical Center | 9133373152 | Practice locations: Omaha, NE |
Care Compare: Ambulatory surgical center
Medicare Care Compare- Listed as
- Pacific Surgery Center
- Medicare certification status
- Active
National Provider Directory
National Provider Directory- Tax ID family
- Pacific Surgery Center
Other organizations with this tax ID 1
Organizations that report the same tax identification number in the National Provider Directory.
-
- Ambulatory Surgical Clinic/Center
- Omaha, NE
- NPI 1902795289
Locations
10707 Pacific St
Ste 100
Omaha, NE 68114
Phone (402) 399-7817
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1343088000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1376870400000",
"number": "1720334097",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6128 S LYNCREST AVE",
"city": "SIOUX FALLS",
"state": "SD",
"postal_code": "571082560",
"telephone_number": "855-334-2955",
"fax_number": "605-274-6186"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "10707 PACIFIC ST STE 100",
"city": "OMAHA",
"state": "NE",
"postal_code": "681144762",
"telephone_number": "402-933-1844",
"fax_number": "402-932-5891"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "PACIFIC SURGERY CENTER, LLC",
"organizational_subpart": "NO",
"enumeration_date": "2012-07-24",
"last_updated": "2013-08-19",
"status": "A",
"authorized_official_last_name": "DESOUZA",
"authorized_official_first_name": "EUCLID",
"authorized_official_title_or_position": "BOARD MEMBER",
"authorized_official_telephone_number": "402-391-2166",
"authorized_official_name_prefix": "Dr."
},
"taxonomies": [
{
"code": "261QA1903X",
"taxonomy_group": "",
"desc": "Clinic/Center, Ambulatory Surgical",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PTAN",
"identifier": "NA2347",
"state": "NE"
}
],
"endpoints": [],
"other_names": []
}Other providers in Omaha, NE
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 19, 2013; 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.