NPIMap

Organization Active NPI

Laurel Laser & Surgery Center, L.P.

  • Ambulatory Surgical Clinic/Center
  • Brookville, PA
National Provider Identifier
1821093204
Registry record updated Jun 10, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X
License
11351500 Issued in PA
Legal business name
LAUREL LASER & SURGERY CENTER, L.P.
Practice address
52 Waterford Pike
Brookville, PA 15825-2518
Phone
(814) 849-0898
Fax
(814) 849-2890
NPI assigned
Jun 14, 2005
Last updated
Jun 10, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 10, 2024

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

Authorized official

Name
Whitney N Sutley, RN
Title
Clinical Director / Administrator
Phone
(814) 849-6561

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ambulatory Surgical Clinic/Center 261QA1903X 11351500 PA Primary

Addresses

Primary practice location

52 Waterford Pike
Brookville, PA 15825-2518

Mailing address

52 Waterford Pike
Brookville, PA 15825-2518
Phone (814) 849-0898

Other identifiers 6

IdentifierTypeStateIssuer
001805435MedicaidPA
1343OtherHIGHMARK BLUE CROSS BLUE
138792OtherHEALTH AMERICA/ASSURANCE
2326303OtherAETNA
216106OtherPAUPMC
490004660OtherRAILROAD MEDICARE

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20080528000530 PA Part B Supplier - Ambulatory Surgical Center 3678677226 Receives reassigned benefits from 10 practitioners
Practice locations: Brookville, PA

Other NPIs with the same Medicare PAC ID 1

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

Care Compare: Ambulatory surgical center

Medicare Care Compare
Listed as
Laurel Laser and Surgery Center LPCCN 39C0001089
Medicare certification status
ActiveFrom the Provider of Services file

National Provider Directory

National Provider Directory
Tax ID family
Laurel Laser Surgery Center2 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.

Practitioners & affiliated clinicians

Practitioners 10

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": "1118707200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1717977600000",
    "number": "1821093204",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "52 WATERFORD PIKE",
            "city": "BROOKVILLE",
            "state": "PA",
            "postal_code": "158252518",
            "telephone_number": "814-849-0898",
            "fax_number": "814-849-2890"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "52 WATERFORD PIKE",
            "city": "BROOKVILLE",
            "state": "PA",
            "postal_code": "158252518",
            "telephone_number": "814-849-0898",
            "fax_number": "814-849-2890"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LAUREL LASER & SURGERY CENTER, L.P.",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-06-14",
        "last_updated": "2024-06-10",
        "certification_date": "2024-06-10",
        "status": "A",
        "authorized_official_last_name": "SUTLEY",
        "authorized_official_first_name": "WHITNEY",
        "authorized_official_middle_name": "N",
        "authorized_official_title_or_position": "CLINICAL DIRECTOR / ADMINISTRATOR",
        "authorized_official_telephone_number": "814-849-6561",
        "authorized_official_credential": "RN"
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": "PA",
            "license": "11351500",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "001805435",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HIGHMARK BLUE CROSS BLUE",
            "identifier": "1343",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTH AMERICA/ASSURANCE",
            "identifier": "138792",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "2326303",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UPMC",
            "identifier": "216106",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "490004660",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Brookville, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 10, 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.