NPIMap

Organization Active NPI

Surgery Center PLC

  • Ambulatory Surgical Clinic/Center
  • Traverse City, MI
National Provider Identifier
1770577637
Registry record updated Dec 15, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X
Legal business name
SURGERY CENTER PLC
Practice address
5080 N Royal Dr
Traverse City, MI 49684-9230
Phone
(231) 929-2500
Fax
(231) 929-0963
NPI assigned
Sep 7, 2005
Last updated
Dec 15, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 15, 2021

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

Authorized official

Name
Dr. Bradley S. Hochstetler, M.D.
Title
Owner
Phone
(231) 929-2500

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207W00000X TH048021 MI
Ambulatory Surgical Clinic/Center 261QA1903X Primary

Addresses

Primary practice location

5080 N Royal Dr
Traverse City, MI 49684-9230

Mailing address

5080 N Royal Dr
Traverse City, MI 49684-9230
Phone (231) 929-2500

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20091001000560 MI Part B Supplier - Ambulatory Surgical Center 0345141016 Receives reassigned benefits from 8 practitioners
Practice locations: Traverse City, MI

Care Compare: Ambulatory surgical center

Medicare Care Compare
Listed as
The Surgery CenterCCN 23C0001034
Medicare certification status
ActiveFrom the Provider of Services file

National Provider Directory

National Provider Directory
Tax ID family
The Surgery Center3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

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

Practitioners & affiliated clinicians

Practitioners 18

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.

View all 18

NPI Registry JSON

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

{
    "created_epoch": "1126051200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1639526400000",
    "number": "1770577637",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5080 N ROYAL DR",
            "city": "TRAVERSE CITY",
            "state": "MI",
            "postal_code": "496849230",
            "telephone_number": "231-929-2500",
            "fax_number": "231-929-0963"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5080 N ROYAL DR",
            "city": "TRAVERSE CITY",
            "state": "MI",
            "postal_code": "496849230",
            "telephone_number": "231-929-2500",
            "fax_number": "231-929-0963"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SURGERY CENTER PLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-09-07",
        "last_updated": "2021-12-15",
        "certification_date": "2021-12-09",
        "status": "A",
        "authorized_official_last_name": "HOCHSTETLER",
        "authorized_official_first_name": "BRADLEY",
        "authorized_official_middle_name": "S.",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "231-929-2500",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Ophthalmology",
            "state": "MI",
            "license": "TH048021",
            "primary": false
        },
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Traverse City, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 15, 2021; 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.