Erie Shores Surgery Center LLC

Primary specialty

Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X

Legal business name

ERIE SHORES SURGERY CENTER LLC

Practice address

2800 Hayes Ave BLDG E
Sandusky, OH 44870-7255

Phone

(419) 627-8557

NPI assigned

May 23, 2019

Organization subpart

No

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

Authorized official

Name

Robert Moore

Title

Manager

Phone

(419) 627-8557

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in OH

Enrollment records 1

Listed as

Erie Shores Surgery Center LLCCCN 36C0001322

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

Member of 1

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

• Firelands Regional Medical Center

  • Renal Dialysis Technician
  • Bellevue, OH
  • NPI 1376780379

  Member Of

  NPD member

Practitioners 1

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

• George Cajetan Stepanic Jr., DO

  • Orthopaedic Surgery Physician
  • Clyde, OH
  • NPI 1881687192
  NPD

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

{
    "created_epoch": "1558569600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1663286400000",
    "number": "1750948873",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2800 HAYES AVE BLDG E",
            "city": "SANDUSKY",
            "state": "OH",
            "postal_code": "448707255"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2800 HAYES AVE BLDG E",
            "city": "SANDUSKY",
            "state": "OH",
            "postal_code": "448707255",
            "telephone_number": "419-627-8557"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ERIE SHORES SURGERY CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-05-23",
        "last_updated": "2022-09-16",
        "certification_date": "2022-09-16",
        "status": "A",
        "authorized_official_last_name": "MOORE",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "419-627-8557"
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Erie Huron Ottawa Educational Service Center
• Erie Medical Review LLC
• Erie Neurosurgery & Assoc, Inc
• Erie Residential Living, Inc.
• Erie Shore Network, Inc.
• Brookelyn Ernst, LSW
• Shannon Erskine
• Daniel Vicente Escovar, D.D.S.
• Amy Espinoza, HHA
• Ethel J. Roldan Center for Cultural Awareness Inc.

• Ambulatory Surgical Clinic/Center in Sandusky, OH
• Providers in Sandusky, 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 Sep 16, 2022; 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.