Philadelphia Surgi Center, Inc.

Primary specialty

Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X

License

10781500 Issued in PA

Legal business name

PHILADELPHIA SURGI CENTER, INC.

Practice address

9500 Roosevelt Blvd
Philadelphia, PA 19115-3926

Phone

(215) 969-5650

Fax

(215) 969-5651

NPI assigned

Jun 19, 2006

Organization subpart

No

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

Authorized official

Name

Margaret Ehrhardt

Title

Administrator

Phone

(215) 969-5650

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in PA

Enrollment records 1

Listed as

Philadelphia Surgi Center IncCCN 39C0001076

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

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

{
    "created_epoch": "1150675200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1247443200000",
    "number": "1811932270",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9500 ROOSEVELT BLVD",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191153926",
            "telephone_number": "215-969-5650",
            "fax_number": "215-969-5651"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9500 ROOSEVELT BLVD",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191153926",
            "telephone_number": "215-969-5650",
            "fax_number": "215-969-5651"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PHILADELPHIA SURGI CENTER, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-19",
        "last_updated": "2009-07-13",
        "status": "A",
        "authorized_official_last_name": "EHRHARDT",
        "authorized_official_first_name": "MARGARET",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "215-969-5650"
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": "PA",
            "license": "10781500",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01731215",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Philadelphia Smile Ceter LLC
• Philadelphia Spine and Wellness CNTR.
• Philadelphia Spine Associates
• Philadelphia Supportive Living Solutions
• Philadelphia Supportive Living Solutions LLC
• Philadelphia Surgical, LLC
• Philadelphia University
• Philadelphia Urology Associates PC
• Philadelphia Urosurgical Associates PC
• Philadelphia VA Clinic

• Ambulatory Surgical Clinic/Center in Philadelphia, PA
• Providers in Philadelphia, PA by specialty
• Ambulatory Surgical Clinic/Center in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2009; 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.