Trillium Surgery LLC

Primary specialty

Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X

Legal business name

TRILLIUM SURGERY LLC

Practice address

680 Buckles CT N
Gahanna, OH 43230-6924

Phone

(614) 729-8483

NPI assigned

Dec 28, 2023

Last updated

Dec 28, 2023By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Srikrishna MannavaNPI 1780727255

Title

Owner

Phone

(614) 729-8483

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in OH

Enrollment records 1

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1730958067. Details of each certification follow.

• CCN 36C0001365 Ambulatory surgical center · Active · Name & address match · Details

Ambulatory surgical center certification: CCN 36C0001365

Legal name

Trillium Surgery LLC

Certification status

Active

Provider type (POS)

Ambulatory surgical center

Participating since

Jan 22, 2025

Last certification

Jan 22, 2025

Facility address

680 Buckles Court North, Suite 2D
Gahanna, OH 43230

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 3

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.

• Srikrishna Mannava, M.D.

  • Vascular Surgery Physician
  • Reynoldsburg, OH
  • NPI 1780727255
  NPD Authorized official
• Lindsay Marie Claggett, CNP

  • Adult Health Nurse Practitioner
  • Gahanna, OH
  • NPI 1578271649
  NPD
• Mamdouh Khayat, MD

  • Vascular & Interventional Radiology Physician
  • Columbus, OH
  • NPI 1780941583
  NPD

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

{
    "created_epoch": "1703721600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1703721600000",
    "number": "1730958067",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "680 BUCKLES CT N STE 2D",
            "city": "GAHANNA",
            "state": "OH",
            "postal_code": "432306924",
            "telephone_number": "614-729-8483"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "680 BUCKLES CT N",
            "city": "GAHANNA",
            "state": "OH",
            "postal_code": "432306924",
            "telephone_number": "614-729-8483"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TRILLIUM SURGERY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-12-28",
        "last_updated": "2023-12-28",
        "certification_date": "2023-12-28",
        "status": "A",
        "authorized_official_last_name": "MANNAVA",
        "authorized_official_first_name": "SRIKRISHNA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "614-729-8483"
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Cory Michael Townsend, AT
• Zachary Townsend, D.O.
• Angela E Tracy, LPCC
• Traditions at Stygler Road (Traditions at Stygler Commons)
• Translink, Inc. MTC
• Trilogy Healthcare of Gahanna, LLC (Taylor Springs Health Campus)
• Trilogy Transportation, LLC
• Trinity Home Healthcare, LLC
• Andrew C Trout, D.O.
• Todd David Troy, PA-C

• Ambulatory Surgical Clinic/Center in Gahanna, OH
• Providers in Gahanna, OH by specialty
• Ambulatory Surgical Clinic/Center in Ohio

• 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; 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.