NPIMap

Organization Active NPI

Proliance Surgeons, Inc., P.S.

Doing business as Seattle Surgery Center

  • Ambulatory Surgical Clinic/Center
  • Seattle, WA
National Provider Identifier
1811936990
Registry record updated May 28, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X
License
601484763 Issued in WA
Legal business name
PROLIANCE SURGEONS, INC., P.S.
Doing business as
Seattle Surgery Center
Practice address
900 Terry Ave FL 3
Seattle, WA 98104-4232
Phone
(206) 382-1021
Fax
(206) 382-9369
NPI assigned
Jun 5, 2006
Last updated
May 28, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 28, 2021

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

Authorized official

Name
Mrs. Laura Kleisle
Title
Chief Risk Officer
Phone
(206) 838-2590

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ambulatory Surgical Clinic/Center 261QA1903X 601484763 WA Primary

Addresses

Primary practice location

900 Terry Ave FL 3
Seattle, WA 98104-4232

Mailing address

900 Terry Ave FL 3
Seattle, WA 98104-4232
Phone (206) 382-1021

Other identifiers 2

IdentifierTypeStateIssuer
208954OtherWAWA L&I
1045762MedicaidWA

Other names 1

  • Seattle Surgery Center Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA3 enrollments

Enrollment records 3

Enrollment IDStateProvider typePAC IDDetails
O20031119000128 WA Part B Supplier - Clinic/Group Practice 8527972900 Receives reassigned benefits from 781 practitioners
This NPI is an additional NPI on the enrollment
O20031208000102 WA Part B Supplier - Ambulatory Surgical Center 8527972900 14 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Kirkland, WA
O20040224000589 WA Part B Supplier - Clinic/Group Practice 6901792365 Receives reassigned benefits from 229 practitioners
3 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Bellevue, WA; Seattle, WA; Redmond, WA; Issaquah, WA; Edmonds, WA

Other NPIs on the same Medicare enrollment 17

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

View all 17

Care Compare: Ambulatory surgical center

Medicare Care Compare
Listed as
Proliance Surgeons Inc PSCCN 50C0001031
Medicare certification status
Terminated Voluntary: merger or closure, Oct 1, 2023From the Provider of Services file

National Provider Directory

National Provider Directory
Tax ID family
Physicians Anesthesia Service PLLC3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

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

Locations

1229 Madison St
Ste 1440
Seattle, WA 98104
Phone (206) 625-0578

Practitioners & affiliated clinicians

Practitioners 50

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.

View all 50

NPI Registry JSON

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

{
    "created_epoch": "1149465600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1622160000000",
    "number": "1811936990",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "900 TERRY AVE FL 3",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981044232",
            "telephone_number": "206-382-1021",
            "fax_number": "206-382-1026"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "900 TERRY AVE FL 3",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981044232",
            "telephone_number": "206-382-1021",
            "fax_number": "206-382-9369"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROLIANCE SURGEONS, INC., P.S.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-05",
        "last_updated": "2021-05-28",
        "certification_date": "2021-05-28",
        "status": "A",
        "authorized_official_last_name": "KLEISLE",
        "authorized_official_first_name": "LAURA",
        "authorized_official_title_or_position": "CHIEF RISK OFFICER",
        "authorized_official_telephone_number": "206-838-2590",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": "WA",
            "license": "601484763",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WA L&I",
            "identifier": "208954",
            "state": "WA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1045762",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Seattle Surgery Center",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Seattle Surgery Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Seattle, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 28, 2021; 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.