Organization Active NPI

Cornerstone Surgical Suites, LLC

  • Ambulatory Surgical Clinic/Center
  • Westminster, CO
National Provider Identifier
1790557312
Registry record updated Nov 9, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X
Legal business name
CORNERSTONE SURGICAL SUITES, LLC
Practice address
7237 Church Ranch Blvd Unit 408
Westminster, CO 80021-6064
Phone
(303) 339-4056
Fax
(303) 339-4061
NPI assigned
Oct 26, 2023
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 9, 2023

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

Authorized official

Name
Lauren Mactaggert, MD
Title
Ceo
Phone
(206) 819-2216

Specialties & licenses 1

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

Addresses

Primary practice location

7237 Church Ranch Blvd Unit 408
Westminster, CO 80021-6064

Mailing address

6798 Villa LN
Berthoud, CO 80513-9001
Phone (720) 252-3994

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20240208003664 CO Part B Supplier - Ambulatory Surgical Center 7113360942 Practice locations: Westminster, CO

Ambulatory surgical center certification: CCN 06C0001207

Name & address match This certification has no NPI in the Medicare enrollment files. CMS publishes enrollment files for six facility types only, so it was connected to this NPI by matching the name and address CMS publishes for it.

Legal name
CORNERSTONE SURGICAL SUITES LLC
Certification status
Active
Provider type (POS)
Ambulatory surgical center
Participating since
Jun 19, 2024
Last certification
Jun 19, 2024
Ownership / control type
Proprietary
Facility address
7237 Church Ranch Blvd. Unit 408
Westminster, CO 80021

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
06D2297721Cornerstone Surgical Suites, LLC7237 Church Ranch Blvd, Suite 408, Westminster, CO 80021Certificate of waiverJan 21, 2028

National Provider Directory

National Provider Directory

Locations

7237 Church Ranch Blvd
Broomfield, CO 80021

7237 Church Ranch Blvd
Unit 407
Westminster, CO 80021

7237 Church Ranch Blvd
Unit 408
Westminster, CO 80021
Phone (303) 339-4056

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1698278400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1699488000000",
    "number": "1790557312",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6798 VILLA LN",
            "city": "BERTHOUD",
            "state": "CO",
            "postal_code": "805139001",
            "telephone_number": "720-252-3994"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7237 CHURCH RANCH BLVD UNIT 408",
            "city": "WESTMINSTER",
            "state": "CO",
            "postal_code": "800216064",
            "telephone_number": "303-339-4056",
            "fax_number": "303-339-4061"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CORNERSTONE SURGICAL SUITES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-10-26",
        "last_updated": "2023-11-09",
        "certification_date": "2023-11-09",
        "status": "A",
        "authorized_official_last_name": "MACTAGGERT",
        "authorized_official_first_name": "LAUREN",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "206-819-2216",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Westminster, CO

Sources for this page

Verify at the official NPI Registry.