NPIMap

Organization Active NPI

Associated Surgical Center of Dearborn LLC

  • Ambulatory Surgical Clinic/Center
  • Dearborn Heights, MI
National Provider Identifier
1760770903
Registry record updated Sep 1, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X
Legal business name
ASSOCIATED SURGICAL CENTER OF DEARBORN LLC
Practice address
24420 Ford Rd
Dearborn Heights, MI 48127-3233
Phone
(734) 673-5917
NPI assigned
Jul 20, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 1, 2014

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

Authorized official

Name
Dr. Mazin Yaldo, MD
Title
Owner
Phone
(313) 202-9400

Specialties & licenses 1

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

Addresses

Primary practice location

24420 Ford Rd
Dearborn Heights, MI 48127-3233

Mailing address

24420 Ford Rd
Dearborn Heights, MI 48127-3233
Phone (734) 673-5917

Other identifiers 1

IdentifierTypeStateIssuer
DH1373OtherMIRR PTAN

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20150715001365 MI Part B Supplier - Ambulatory Surgical Center 6204149586 Receives reassigned benefits from 5 practitioners
Practice locations: Dearborn Heights, MI

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
Associated Surgical Center of Dearborn LLCCCN 23C0001047
Medicare certification status
ActiveFrom the Provider of Services file

National Provider Directory

National Provider Directory
Tax ID family
Associated Surgical Center2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

Member of 1

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

Practitioners & affiliated clinicians

Practitioners 6

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

NPI Registry JSON

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

{
    "created_epoch": "1311120000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1409529600000",
    "number": "1760770903",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "24420 FORD RD",
            "city": "DEARBORN HEIGHTS",
            "state": "MI",
            "postal_code": "481273233",
            "telephone_number": "734-673-5917",
            "fax_number": "314-667-6915"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "24420 FORD RD",
            "city": "DEARBORN HEIGHTS",
            "state": "MI",
            "postal_code": "481273233",
            "telephone_number": "734-673-5917"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ASSOCIATED SURGICAL CENTER OF DEARBORN LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-07-20",
        "last_updated": "2014-09-01",
        "status": "A",
        "authorized_official_last_name": "YALDO",
        "authorized_official_first_name": "MAZIN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "313-202-9400",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR PTAN",
            "identifier": "DH1373",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Dearborn Heights, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 1, 2014; 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.