Queensridge Surgery Center

Primary specialty

Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X

Legal business name

QUEENSRIDGE SURGERY CENTER

Practice address

10040 Alta Drive
Suite 210
Las Vegas, NV 89145

Phone

(702) 589-9250

Fax

(702) 589-9257

NPI assigned

May 20, 2022

Last updated

May 20, 2022By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Robert Lerma, MBA, CASC

Title

Administrator

Phone

(702) 589-9250

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NV

Enrollment records 1

Listed as

Queensridge Surgery Center LLCCCN 29C0001139

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

Locations

Practitioners 1

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.

• Michael J Crovetti Jr., DO

  • Orthopaedic Surgery Physician
  • Henderson, NV
  • NPI 1033269147
  NPD

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

{
    "created_epoch": "1653004800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1653004800000",
    "number": "1780322750",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2779 W HORIZON RIDGE PKWY STE 140",
            "city": "HENDERSON",
            "state": "NV",
            "postal_code": "890524186",
            "telephone_number": "702-589-9250",
            "fax_number": "702-589-9257"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10040 ALTA DRIVE",
            "address_2": "SUITE 210",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "89145",
            "telephone_number": "702-589-9250",
            "fax_number": "702-589-9257"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "QUEENSRIDGE SURGERY CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-05-20",
        "last_updated": "2022-05-20",
        "certification_date": "2022-05-05",
        "status": "A",
        "authorized_official_last_name": "LERMA",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "702-589-9250",
        "authorized_official_credential": "MBA, CASC"
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Doris Ann Queen
• Kaelani Maj Queen
• Linda Marie Queen
• Michael Queensborough
• Queensridge Cardiology Center LLC
• Ashton-Travis Queja, DMD
• James Quenzler
• Rosaline Elizabeth Quero
• Rey Anthony Querol, RN
• Hector Querubin

• Ambulatory Surgical Clinic/Center in Las Vegas, NV
• Providers in Las Vegas, NV by specialty
• Ambulatory Surgical Clinic/Center in Nevada

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