NPIMap

Organization Active NPI

Wiregrass Ranch ASC Holdings LLC

Doing business as Wiregrass Ranch Ambulatory Surgery Center

  • Ambulatory Surgical Clinic/Center
  • Tampa, FL
National Provider Identifier
1750456539
Registry record updated Oct 3, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X
License
1189 Issued in FL
Legal business name
WIREGRASS RANCH ASC HOLDINGS LLC
Doing business as
Wiregrass Ranch Ambulatory Surgery Center
Practice address
14547 Bruce B Downs Blvd
Tampa, FL 33613-2709
Phone
(813) 978-1494
Fax
(813) 615-0296
NPI assigned
Nov 21, 2006
Last updated
Oct 3, 2024By the provider in NPPES
Organization subpart
Yes
Parent organization
WIREGRASS RANCH ASC HOLDINGS LLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Oct 3, 2024

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

Authorized official

Name
Gaurav Sood
Title
VP of Ambulatory Surgery Centers
Phone
(321) 841-8346

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ambulatory Surgical Clinic/Center 261QA1903X 1189 FL Primary

Addresses

Primary practice location

14547 Bruce B Downs Blvd
Tampa, FL 33613-2709

Mailing address

14547 Bruce B Downs Blvd
Tampa, FL 33613-2709
Phone (813) 979-0440

Other identifiers 1

IdentifierTypeStateIssuer
1189OtherFLLICENSE #

Other names 1

  • Wiregrass Ranch Ambulatory Surgery Center Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20240624004677 FL Part B Supplier - Ambulatory Surgical Center 9436692035 Practice locations: Tampa, FL

Other NPIs with the same Medicare PAC ID 1

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

Care Compare: Ambulatory surgical center

Medicare Care Compare
Listed as
Florida Medical Clinic PACCN 10C0001413
Medicare certification status
ActiveFrom the Provider of Services file

Laboratory certificates & supplier records

Derived by NPIMap

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

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
10D1017168Wiregrass Ranch Ambulatory Surgery Center14547 Bruce B Downs Blvd, Tampa, FL 33613Certificate of waiverSep 17, 2027

National Provider Directory

National Provider Directory
Tax ID family
Wiregrass Ranch ASC Holdings LLC2 organizations share this tax ID, including this one
Part of
Wiregrass Ranch ASC Holdings LLC

Other organizations with this tax ID 1

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

Locations

701 Cedar Lake Blvd
#10
Oklahoma City, OK 73114

Networks

  • Freedom Health HMO NetworkPlans: Freedom Platinum Rewards Plan Rx (HMO) (H5427-102-000, H5427); Freedom VIP Care (HMO C-SNP) (H5427-070-000, H5427); Freedom VIP Rewards (HMO C-SNP) (H5427-108-000, H5427); Freedom VIP Rewards (HMO C-SNP) (H5427-099-000, H5427); Freedom Platinum Rewards Plan Rx (HMO) (H5427-107-000, H5427); Freedom Máximo (HMO-POS) (H5427-113-000, H5427); Freedom Savings Plan (HMO) (H5427-052-000, H5427); Freedom Platinum Rewards Plan Rx (HMO) (H5427-096-000, H5427); Freedom Platinum Rewards Plan Rx (HMO) (H5427-105-000, H5427); Freedom Medi-Medi Full (HMO D-SNP) (H5427-087-000, H5427)…
  • Optimum HealthCare HMO NetworkPlans: Optimum Diamond Rewards (HMO C-SNP) (H5594-028-000, H5594); Optimum Diamond (HMO C-SNP) (H5594-036-000, H5594); Optimum Diamond Rewards (HMO C-SNP) (H5594-034-000, H5594); Optimum Diamond Rewards COPD (HMO C-SNP) (H5594-029-000, H5594); Optimum Platinum Plan (HMO) (H5594-002-000, H5594); Optimum Gold Plus Plan (HMO) (H5594-032-000, H5594); Optimum Diamond Savings COPD (HMO C-SNP) (H5594-031-000, H5594); Optimum Diamond Savings (HMO C-SNP) (H5594-030-000, H5594); Optimum Diamond Rewards COPD (HMO C-SNP) (H5594-035-000, H5594)

Practitioners & affiliated clinicians

Practitioners 9

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.

NPI Registry JSON

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

{
    "created_epoch": "1164067200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1727913600000",
    "number": "1750456539",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14547 BRUCE B DOWNS BLVD",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336132709",
            "telephone_number": "813-979-0440",
            "fax_number": "813-615-0296"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14547 BRUCE B DOWNS BLVD",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336132709",
            "telephone_number": "813-978-1494",
            "fax_number": "813-615-0296"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WIREGRASS RANCH ASC HOLDINGS LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "WIREGRASS RANCH ASC HOLDINGS LLC",
        "enumeration_date": "2006-11-21",
        "last_updated": "2024-10-03",
        "certification_date": "2024-10-03",
        "status": "A",
        "authorized_official_last_name": "SOOD",
        "authorized_official_first_name": "GAURAV",
        "authorized_official_title_or_position": "VP OF AMBULATORY SURGERY CENTERS",
        "authorized_official_telephone_number": "321-841-8346"
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": "FL",
            "license": "1189",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE #",
            "identifier": "1189",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Wiregrass Ranch Ambulatory Surgery Center",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Wiregrass Ranch Ambulatory Surgery Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Tampa, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 3, 2024; 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.