Active NPI
Surgery Center PLC
- Ambulatory Surgical Clinic/Center
- Traverse City, MI
National Provider Identifier
1770577637
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Ambulatory Surgical Clinic/Center
- 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
- Organization subpart
- No
NPPES NPI Registry
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) | Code | License | State | Primary |
|---|---|---|---|---|
| Ophthalmology Physician | 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
Other identifiers 6
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 050B810950 | Other | MI | BCBS MD ANES GROUP |
| 40364 | Other | MI | BCBS - TSC |
| 900003210 | Other | MI | PRIORITY - TSC |
| 430B810310 | Other | MI | BCBS CRNA GROUP |
| 490003947 | Other | MI | MEDICARE RR |
| 490B870000 | Other | MI | BCBS |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MI
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| 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 Center
- Medicare certification status
- Active
National Provider Directory
National Provider Directory- Tax ID family
- The Surgery Center
Other organizations with this tax ID 2
Organizations that report the same tax identification number in the National Provider Directory.
-
- Certified Registered Nurse Anesthetist
- Traverse City, MI
- NPI 1225256324
-
- Anesthesiology Physician
- Traverse City, MI
- NPI 1902024003
Practitioners & affiliated clinicians
Practitioners 18
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Certified Registered Nurse Anesthetist
- Traverse City, MI
- NPI 1851353916
MI
-
- Certified Registered Nurse Anesthetist
- Traverse City, MI
- NPI 1033103874
MI
-
- Certified Registered Nurse Anesthetist
- Traverse City, MI
- NPI 1164402129
-
- Anesthesiology Physician
- Traverse City, MI
- NPI 1447239652
-
- Certified Registered Nurse Anesthetist
- Charlevoix, MI
- NPI 1689762379
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": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS MD ANES GROUP",
"identifier": "050B810950",
"state": "MI"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS - TSC",
"identifier": "40364",
"state": "MI"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PRIORITY - TSC",
"identifier": "900003210",
"state": "MI"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS CRNA GROUP",
"identifier": "430B810310",
"state": "MI"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICARE RR",
"identifier": "490003947",
"state": "MI"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS",
"identifier": "490B870000",
"state": "MI"
}
],
"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.