Westside Surgery Center, LLC

Primary specialty

Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X

License

07-1548 Issued in OR

Legal business name

WESTSIDE SURGERY CENTER, LLC

Practice address

13240 SW Pacific Hwy
Suite 200
Tigard, OR 97223-4828

Phone

(503) 639-6571

Fax

(503) 624-6037

NPI assigned

Nov 10, 2005

Organization subpart

No

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

Authorized official

Name

Brett Williams

Title

Ceo

Phone

(503) 558-7372

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in OR

Enrollment records 1

Listed as

Westside Surgery Center LLCCCN 38C0001013

Medicare certification status

ActiveFrom the Provider of Services file

Tax ID family

Westside Surgery Center LLC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

• Westside Surgery Center, LLC

  • Durable Medical Equipment & Medical Supplies
  • Tigard, OR
  • NPI 1992788004
  NPD tax ID

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

{
    "created_epoch": "1131580800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1708560000000",
    "number": "1811978356",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11086 SE OAK ST",
            "city": "MILWAUKIE",
            "state": "OR",
            "postal_code": "972226692",
            "telephone_number": "503-557-2020",
            "fax_number": "503-344-5110"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13240 SW PACIFIC HWY",
            "address_2": "SUITE 200",
            "city": "TIGARD",
            "state": "OR",
            "postal_code": "972234828",
            "telephone_number": "503-639-6571",
            "fax_number": "503-624-6037"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WESTSIDE SURGERY CENTER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-11-10",
        "last_updated": "2024-02-22",
        "certification_date": "2024-02-22",
        "status": "A",
        "authorized_official_last_name": "WILLIAMS",
        "authorized_official_first_name": "BRETT",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "503-558-7372"
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": "OR",
            "license": "07-1548",
            "primary": true
        },
        {
            "code": "261QS0132X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ophthalmologic Surgery",
            "state": "OR",
            "license": "07-1548",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "275090",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Natalie West, LE
• Jesika B Westbrook
• Western Psychological and Counseling Services PC
• Westside Podiatry Clinic LLC
• Westside Sleep Center, LLC
• Westside Surgery Center, LLC
• Matthew E Wettig
• Donald Woodin Wheatley, DC
• Anne Wheeler
• Arielle Wheeler

• Ambulatory Surgical Clinic/Center in Tigard, OR
• Providers in Tigard, OR by specialty
• Ambulatory Surgical Clinic/Center in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 22, 2024; 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.