Trevose Specialty Care Surgical Center, LLC

Primary specialty

Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X

License

22411501 Issued in PA

Legal business name

TREVOSE SPECIALTY CARE SURGICAL CENTER, LLC

Practice address

4979 Old Street Rd
Trevose, PA 19053-6222

Phone

(267) 684-6047

Fax

(267) 684-6056

NPI assigned

May 27, 2008

Organization subpart

No

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

Authorized official

Name

Steven Rosen, MD

Title

Managing Partner

Phone

(267) 684-6047

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in PA

Enrollment records 1

Listed as

Trevose Specialty Care Surgical Center LLCCCN 39C0001272

Medicare certification status

ActiveFrom the Provider of Services file

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

CLIA laboratory certificates

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Thomas P Costello, D.O.

  • Pain Medicine (Anesthesiology) Physician
  • Fort Lauderdale, FL
  • NPI 1659570331
  NPD

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

{
    "created_epoch": "1211846400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1529539200000",
    "number": "1740448711",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4979 OLD STREET RD",
            "city": "TREVOSE",
            "state": "PA",
            "postal_code": "190536222",
            "telephone_number": "267-684-6047",
            "fax_number": "267-684-6056"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4979 OLD STREET RD",
            "city": "TREVOSE",
            "state": "PA",
            "postal_code": "190536222",
            "telephone_number": "267-684-6047",
            "fax_number": "267-684-6056"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TREVOSE SPECIALTY CARE SURGICAL CENTER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-05-27",
        "last_updated": "2018-06-21",
        "status": "A",
        "authorized_official_last_name": "ROSEN",
        "authorized_official_first_name": "STEVEN",
        "authorized_official_title_or_position": "MANAGING PARTNER",
        "authorized_official_telephone_number": "267-684-6047",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": "PA",
            "license": "22411501",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Stephen Joseph Sullivan Jr., DC
• Raymond Tainan, MA
• Terrapin West End Pharmacy, LLC
• The Progressions Companies, Inc.
• Transitional Care Solutions
• Priscilla Korto a Tyler, CRNP-PC
• V V L S Pharmacy LLC
• Mammen Cherian Vaidian
• Michelle Verona, RD
• Ava Votta

• Ambulatory Surgical Clinic/Center in Trevose, PA
• Providers in Trevose, PA by specialty
• Ambulatory Surgical Clinic/Center in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 21, 2018; 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.