Southpark Surgery Center, LLC

Primary specialty

Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X

Legal business name

SOUTHPARK SURGERY CENTER, LLC

Practice address

901 Wilson St Ste a
Lafayette, LA 70503-2439

Phone

(512) 220-3824

NPI assigned

Nov 7, 2017

Organization subpart

No

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

Authorized official

Name

Jared Leger

Title

Manager

Phone

(337) 274-6549

Specialties & licenses 1

Addresses

Other names 1

• Cardiovascular Surgery Center Doing business as

Medicare fee-for-service enrollment

Enrolled in LA

Enrollment records 1

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

CLIA laboratory certificates

Locations

Practitioners 8

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

• David E Allie, MD

  • Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
  • Lafayette, LA
  • NPI 1760489728
  Medicare reassignment NPD
• Kyle Jacob Degeyter, MD

  • Vascular & Interventional Radiology Physician
  • Lafayette, LA
  • NPI 1083840888
  Medicare reassignment NPD
• Albert J Gros Jr., MD

  • Interventional Pain Medicine Physician
  • Opelousas, LA
  • NPI 1457395832
  Medicare reassignment NPD
• Michael Hoss, M.D.

  • Vascular & Interventional Radiology Physician
  • Lafayette, LA
  • NPI 1447679501
  Medicare reassignment NPD
• Robert S Lewis, MD

  • Cardiovascular Disease Physician
  • New Iberia, LA
  • NPI 1093737728
  Medicare reassignment NPD
• Brent J Rochon, MD

  • Cardiovascular Disease Physician
  • Lafayette, LA
  • NPI 1700874443
  Medicare reassignment NPD
• Jose Antonio Silva, M.D.

  • Interventional Cardiology Physician
  • Slidell, LA
  • NPI 1790765394
  Medicare reassignment NPD
• Corwin Ashford Thomas, D.O.

  • Cardiovascular Disease Physician
  • Lafayette, LA
  • NPI 1013920362
  Medicare reassignment NPD

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

{
    "created_epoch": "1510012800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1582156800000",
    "number": "1770096273",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13830 SAWYER RANCH RD STE 105",
            "city": "DRIPPING SPRINGS",
            "state": "TX",
            "postal_code": "786205514"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "901 WILSON ST STE A",
            "city": "LAFAYETTE",
            "state": "LA",
            "postal_code": "705032439",
            "telephone_number": "512-220-3824"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHPARK SURGERY CENTER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-11-07",
        "last_updated": "2020-02-20",
        "certification_date": "2020-02-20",
        "status": "A",
        "authorized_official_last_name": "LEGER",
        "authorized_official_first_name": "JARED",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "337-274-6549"
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Cardiovascular Surgery Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Southpark Acquisition Company LLC
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• Southpark Community Hospital
• Southwest Imaging Associates, Apmc
• Southwest Louisiana Area Health Education Center
• Southwest Louisiana Breast Surgeons LLC
• Southwest Louisiana Independence Center Inc.
• Southwest Louisiana Independence Center Inc.

• Ambulatory Surgical Clinic/Center in Lafayette, LA
• Providers in Lafayette, LA by specialty
• Ambulatory Surgical Clinic/Center in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 20, 2020; 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.