Michigan Ambulatory Surgical Center, LLC

Primary specialty

Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X

Legal business name

MICHIGAN AMBULATORY SURGICAL CENTER, LLC

Practice address

22000 Greenfield Rd
Oak Park, MI 48237-2500

Phone

(248) 206-2990

Fax

(248) 206-2991

NPI assigned

Feb 14, 2014

Organization subpart

No

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

Authorized official

Name

Ms. Justine Breckenridge Corday

Title

Administrator

Phone

(248) 206-2990

Specialties & licenses 1

Addresses

Other names 1

• Specialty Surgical Center Doing business as

Medicare fee-for-service enrollment

Enrolled in MI

Enrollment records 1

Listed as

Specialty Surgical CtrCCN 23C0001126

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

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

{
    "created_epoch": "1392336000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1586822400000",
    "number": "1790109445",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22000 GREENFIELD RD",
            "city": "OAK PARK",
            "state": "MI",
            "postal_code": "482372500",
            "telephone_number": "248-206-2990",
            "fax_number": "248-206-2991"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22000 GREENFIELD RD",
            "city": "OAK PARK",
            "state": "MI",
            "postal_code": "482372500",
            "telephone_number": "248-206-2990",
            "fax_number": "248-206-2991"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MICHIGAN AMBULATORY SURGICAL CENTER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-02-14",
        "last_updated": "2020-04-14",
        "certification_date": "2020-04-14",
        "status": "A",
        "authorized_official_last_name": "CORDAY",
        "authorized_official_first_name": "JUSTINE",
        "authorized_official_middle_name": "BRECKENRIDGE",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "248-206-2990",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Specialty Surgical Center",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Specialty Surgical Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Ambulatory Surgical Clinic/Center in Oak Park, MI
• Providers in Oak Park, MI by specialty
• Ambulatory Surgical Clinic/Center in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 14, 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.