NPIMap

Organization Active NPI

St Francis Ambulatory Services LLC

  • Ambulatory Surgical Clinic/Center
  • Shakopee, MN
National Provider Identifier
1730864448
Registry record updated Oct 28, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X
Legal business name
ST FRANCIS AMBULATORY SERVICES LLC
Practice address
1700 St Francis Ave
Shakopee, MN 55379
Phone
(952) 993-7800
Fax
(952) 993-7848
NPI assigned
Jun 20, 2023
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 28, 2024

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

Authorized official

Name
Amy Jerdee
Title
President
Phone
(952) 428-2400

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ambulatory Surgical Clinic/Center 261QA1903X Primary

Addresses

Primary practice location

1700 St Francis Ave
Shakopee, MN 55379

Mailing address

1700 St Francis Ave
Ste 100
Shakopee, MN 55379-3374
Phone (612) 262-1166

Other names 1

  • St Francis Surgery and Endoscopy Center Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20241107000305 MN Part B Supplier - Ambulatory Surgical Center 2466986922 Practice locations: Shakopee, MN

Other NPIs with the same Medicare PAC ID 1

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

National Provider Directory

National Provider Directory
Tax ID family
St Francis Ambulatory Services2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

Member of 2

Organizations this organization is a member of, according to the National Provider Directory.

Locations

1700 Saint Francis Ave
Shakopee, MN 55379
Phone (952) 993-7800

1700 Saint Francis Ave
Ste 100
Shakopee, MN 55379
Phone (952) 993-7800

NPI Registry JSON

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

{
    "created_epoch": "1687219200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1730073600000",
    "number": "1730864448",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1700 ST FRANCIS AVE",
            "address_2": "STE 100",
            "city": "SHAKOPEE",
            "state": "MN",
            "postal_code": "553793374",
            "telephone_number": "612-262-1166",
            "fax_number": "612-262-0475"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1700 ST FRANCIS AVE",
            "city": "SHAKOPEE",
            "state": "MN",
            "postal_code": "55379",
            "telephone_number": "952-993-7800",
            "fax_number": "952-993-7848"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ST FRANCIS AMBULATORY SERVICES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-06-20",
        "last_updated": "2024-10-28",
        "certification_date": "2024-10-23",
        "status": "A",
        "authorized_official_last_name": "JERDEE",
        "authorized_official_first_name": "AMY",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "952-428-2400"
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "St Francis Surgery and Endoscopy Center",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "St Francis Surgery and Endoscopy Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Shakopee, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 28, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.