Organization Active NPI

Slate Hill Surgery Center, LLC

  • Ambulatory Surgical Clinic/Center
  • Camp Hill, PA
National Provider Identifier
1801582168
Registry record updated Nov 16, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X
Legal business name
SLATE HILL SURGERY CENTER, LLC
Practice address
3950 Hartzdale Dr
Camp Hill, PA 17011-7828
Phone
(717) 761-5530
Fax
(717) 737-7197
NPI assigned
Apr 11, 2023
Last updated
Nov 16, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 16, 2023

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

Authorized official

Name
Dr. Matthew J Kelly, MDNPI 1093793531
Title
President
Phone
(717) 761-5530

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

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

Addresses

Primary practice location

3950 Hartzdale Dr
Camp Hill, PA 17011-7828

Mailing address

3399 Trindle Rd
Camp Hill, PA 17011-4407
Phone (717) 761-5530

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20231108002276 PA Part B Supplier - Ambulatory Surgical Center 9133576465 Practice locations: Camp Hill, PA

Care Compare: Ambulatory surgical center

Medicare Care Compare
Listed as
Slate Hill Surgery Center LLCCCN 39C0001388
Medicare certification status
ActiveFrom the Provider of Services file

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
39D2290046Slate Hill Surgery Center3950 Hartzdale Drive, Camp Hill, PA 17011Certificate of waiverSep 19, 2027

National Provider Directory

National Provider Directory

Locations

3950 Hartzdale Dr
Camp Hill, PA 17011

Practitioners & affiliated clinicians

Practitioners 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1681171200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1700092800000",
    "number": "1801582168",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3399 TRINDLE RD",
            "city": "CAMP HILL",
            "state": "PA",
            "postal_code": "170114407",
            "telephone_number": "717-761-5530",
            "fax_number": "717-737-7197"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3950 HARTZDALE DR",
            "city": "CAMP HILL",
            "state": "PA",
            "postal_code": "170117828",
            "telephone_number": "717-761-5530",
            "fax_number": "717-737-7197"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SLATE HILL SURGERY CENTER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-04-11",
        "last_updated": "2023-11-16",
        "certification_date": "2023-11-16",
        "status": "A",
        "authorized_official_last_name": "KELLY",
        "authorized_official_first_name": "MATTHEW",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "717-761-5530",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Camp Hill, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 16, 2023; 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.