NPIMap

Organization Active NPI

Surgery Center of Edgewood Place, LLC

  • Ambulatory Surgical Clinic/Center
  • New Castle, PA
National Provider Identifier
1780919043
Registry record updated Nov 17, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X
Legal business name
SURGERY CENTER OF EDGEWOOD PLACE, LLC
Practice address
2 E Laurel Ave
New Castle, PA 16101-2354
Phone
(724) 656-9181
Fax
(724) 656-1340
NPI assigned
Oct 5, 2009
Organization subpart
Yes
Parent organization
SURGERY CENTER AT EDGEWOOD PLACE LLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Nov 17, 2009

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

Authorized official

Name
Michael Torn
Title
Ceo
Phone
(724) 646-0400

Specialties & licenses 1

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

Addresses

Primary practice location

2 E Laurel Ave
New Castle, PA 16101-2354

Mailing address

239 Edgewood Drive Ext
Transfer, PA 16154-1817
Phone (724) 646-0400

Other names 1

  • LAWRENCE COUNTY SURGERY CENTER OF EDGEWOOD SURGICAL HOSPITAL Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040507000522 PA Part A Provider - Hospital 9638168420 1 other NPI on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: New Castle, PA; Transfer, PA

Hospital certification: CCN 390307

Legal name
SURGERY CENTER AT EDGEWOOD PLACE, LLC
Doing business as
EDGEWOOD SURGICAL HOSPITAL
Certification status
Active
Provider type (POS)
Hospital – Short-term
Participating since
Mar 24, 2004
Last certification
Mar 28, 2022
Beds
10
Ownership / control type
Physician ownership
Organization structure
LLCProprietary
Incorporated
Apr 22, 2002 in PA
Enrollment address
239 Edgewood Drive Ext
Transfer, PA 16154-1817
Hospital subgroups
Short-term, Specialty hospital

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

Care Compare: Hospital

Medicare Care Compare
Listed as
Edgewood Surgical HospitalCCN 390307
Type
Acute Care Hospitals
Ownership
Physician
Medicare certification status
ActiveFrom the Provider of Services file
Emergency services
No

National Provider Directory

National Provider Directory
Tax ID family
Surg Ctr at Edgewood Place2 organizations share this tax ID, including this one
Part of
Surg Ctr at Edgewood Place

Other organizations with this tax ID 1

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

Ownership & related parties

All disclosed owners & managing parties 5

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Kapital Development LLC Organization, Sharon, PA LLC 5% Or Greater Direct Ownership Interest Nov 4, 2002
Ryan G Molli Individual 5% Or Greater Indirect Ownership Interest Apr 30, 2020 23%
Corporate Director Jan 1, 2021
Kevin Edward Gramley Individual Limited Partnership Interest May 29, 2020 4.96%
Corporate OfficerCeo May 29, 2020
Kurtis Gramley Individual 5% Or Greater Direct Ownership Interest Nov 4, 2002
W-2 Managing Employee Nov 4, 2002
Operational/Managerial Control Nov 4, 2002
Thomas George Roskos Individual Corporate Director May 29, 2020

Owners & managing parties with NPI records 1

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

  • Ryan G Molli, DO
    • Orthopaedic Surgery Physician
    • Meadville, PA
    • NPI 1861513251

    5% Or Greater Indirect Ownership Interest, Corporate Director

    CMS ownership

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

Practitioners & affiliated clinicians

Affiliated clinicians 41

Clinicians who list this facility as an affiliation in Medicare Care Compare.

View all 41

NPI Registry JSON

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

{
    "created_epoch": "1254700800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1258416000000",
    "number": "1780919043",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "239 EDGEWOOD DRIVE EXT",
            "city": "TRANSFER",
            "state": "PA",
            "postal_code": "161541817",
            "telephone_number": "724-646-0400",
            "fax_number": "724-646-0413"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2 E LAUREL AVE",
            "city": "NEW CASTLE",
            "state": "PA",
            "postal_code": "161012354",
            "telephone_number": "724-656-9181",
            "fax_number": "724-656-1340"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SURGERY CENTER OF EDGEWOOD PLACE, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "SURGERY CENTER AT EDGEWOOD PLACE LLC",
        "enumeration_date": "2009-10-05",
        "last_updated": "2009-11-17",
        "status": "A",
        "authorized_official_last_name": "TORN",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "724-646-0400"
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "LAWRENCE COUNTY SURGERY CENTER OF EDGEWOOD SURGICAL HOSPITAL",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in New Castle, PA

Sources for this page

Verify at the official NPI Registry.