NPIMap

Organization Active NPI

Summit Orthopedics LTD

Doing business as Dba Landmark Surgery Center

  • Ambulatory Surgical Clinic/Center
  • Woodbury, MN
National Provider Identifier
1811973639
Registry record updated Jun 5, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X
License
375355 Issued in MN
Legal business name
SUMMIT ORTHOPEDICS LTD
Doing business as
Dba Landmark Surgery Center
Practice address
7115 Tamarack Rd Ste 200
Woodbury, MN 55125-1208
Phone
(651) 968-5468
Fax
(651) 968-5492
NPI assigned
Dec 22, 2005
Last updated
Jun 5, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 5, 2023

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

Authorized official

Name
Beckie Hines
Title
Director of Surgery Centers
Phone
(651) 968-5438

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ambulatory Surgical Clinic/Center 261QA1903X 375355 MN Primary

Addresses

Primary practice location

7115 Tamarack Rd Ste 200
Woodbury, MN 55125-1208

Mailing address

710 Commerce Dr Ste 200
Woodbury, MN 55125-4925
Phone (651) 968-5201

Other identifiers 4

IdentifierTypeStateIssuer
44038OtherMNHEALTHPARTNERS
6801127OtherMNMEDICA
020718700MedicaidMN
8A11LAOtherMNBLUE CROSS BLUE SHIELD

Other names 1

  • DBA LANDMARK SURGERY CENTER Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20080117000151 MN Part B Supplier - Ambulatory Surgical Center 8921900374 Practice locations: Woodbury, MN

Other NPIs with the same Medicare PAC ID 15

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

View all 15

Care Compare: Ambulatory surgical center

Medicare Care Compare
Listed as
Landmark Surgery CenterCCN 24C0001019
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
24D0958368Landmark Surgery Center7115 Tamarack Rd Suite #200, Woodbury, MN 55125Certificate of waiverMar 16, 2027

National Provider Directory

National Provider Directory
Tax ID family
Vadnais Heights Surgery Center LLC32 organizations share this tax ID, including this one

Other organizations with this tax ID 31

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

View all 31

NPI Registry JSON

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

{
    "created_epoch": "1135209600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1685923200000",
    "number": "1811973639",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "710 COMMERCE DR STE 200",
            "city": "WOODBURY",
            "state": "MN",
            "postal_code": "551254925",
            "telephone_number": "651-968-5201",
            "fax_number": "651-730-3556"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7115 TAMARACK RD STE 200",
            "city": "WOODBURY",
            "state": "MN",
            "postal_code": "551251208",
            "telephone_number": "651-968-5468",
            "fax_number": "651-968-5492"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUMMIT ORTHOPEDICS LTD",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-12-22",
        "last_updated": "2023-06-05",
        "certification_date": "2023-06-05",
        "status": "A",
        "authorized_official_last_name": "HINES",
        "authorized_official_first_name": "BECKIE",
        "authorized_official_title_or_position": "DIRECTOR OF SURGERY CENTERS",
        "authorized_official_telephone_number": "651-968-5438"
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": "MN",
            "license": "375355",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTHPARTNERS",
            "identifier": "44038",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICA",
            "identifier": "6801127",
            "state": "MN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "020718700",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "8A11LA",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "DBA LANDMARK SURGERY CENTER",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "DBA LANDMARK SURGERY CENTER",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Woodbury, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 5, 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.