Elkhart Day Surgery, LLC

Primary specialty

Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X

Legal business name

ELKHART DAY SURGERY, LLC

Practice address

2746 Old US Hwy 20 W.
Ste. C
Elkhart, IN 46514-1364

Phone

(574) 293-8366

Fax

(574) 970-0115

NPI assigned

Nov 14, 2011

Organization subpart

No

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

Authorized official

Name

Hayley G Boling, MBA

Title

Ceo

Phone

(574) 293-3545

Specialties & licenses 1

Addresses

Other names 1

• Insight Surgery Center Doing business as

Medicare fee-for-service enrollment

Enrolled in IN

Enrollment records 1

Listed as

Elkhart Day Surgery LLCCCN 15C0001179

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 4

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

• Megan Nichole Heil, D.O.

  • Ophthalmology Physician
  • Goshen, IN
  • NPI 1134354012
  Medicare reassignment NPD
• Richard Clayton Boling II, M.D.

  • Ophthalmology Physician
  • Elkhart, IN
  • NPI 1245278068
  NPD (past)
• Whitney Boling, M.D.

  • Ophthalmology Physician
  • Elkhart, IN
  • NPI 1629333133
  NPD (past)
• Kevin Clayton Dietrich, M.D.

  • Ophthalmology Physician
  • Elkart, IN
  • NPI 1639597636
  NPD (past)

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

{
    "created_epoch": "1321228800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1438041600000",
    "number": "1750668190",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2746 OLD US HWY 20 W.",
            "address_2": "STE. C",
            "city": "ELKHART",
            "state": "IN",
            "postal_code": "465141364",
            "telephone_number": "574-293-8366",
            "fax_number": "574-970-0115"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2746 OLD US HWY 20 W.",
            "address_2": "STE. C",
            "city": "ELKHART",
            "state": "IN",
            "postal_code": "465141364",
            "telephone_number": "574-293-8366",
            "fax_number": "574-970-0115"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ELKHART DAY SURGERY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-11-14",
        "last_updated": "2015-07-28",
        "status": "A",
        "authorized_official_last_name": "BOLING",
        "authorized_official_first_name": "HAYLEY",
        "authorized_official_middle_name": "G",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "574-293-3545",
        "authorized_official_credential": "MBA"
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": "IN",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Insight Surgery Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Elkhart Community Schools
• Elkhart County Auditor
• Elkhart County Auditor
• Elkhart County Health Department
• Elkhart County Health Department
• Elkhart Dental Center PC
• Elkhart General Hospital Foundation, Inc.
• Elkhart General Hospital Inc
• Elkhart General Hospital Inc
• Elkhart General Hospital Inc

• Ambulatory Surgical Clinic/Center in Elkhart, IN
• Providers in Elkhart, IN by specialty
• Ambulatory Surgical Clinic/Center in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 28, 2015; 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.