Advantage Surgery Center, LLC

Primary specialty

Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X

Legal business name

ADVANTAGE SURGERY CENTER, LLC

Doing business as

Advantage Surgery Center, LLC

Practice address

6424 E Broadway Rd Ste 102
Mesa, AZ 85206-1750

Phone

(480) 634-4606

NPI assigned

Jan 12, 2021

Organization subpart

No

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

Authorized official

Name

Brandie Hernandez

Title

Director of Operations

Phone

(480) 634-4606

Specialties & licenses 1

Addresses

Other names 1

• Advantage Surgery Center, LLC Doing business as

Medicare fee-for-service enrollment

Enrolled in AZ

Enrollment records 1

Ambulatory surgical center certification: CCN 03C0001478

Legal name

ADVANTAGE SURGERY CENTER LLC

Certification status

Active

Provider type (POS)

Ambulatory surgical center

Participating since

Aug 31, 2022

Last certification

Aug 31, 2022

Ownership / control type

Proprietary

Facility address

6424 East Broadway Road, Suite 102
Mesa, AZ 85206

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

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

{
    "created_epoch": "1610409600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1610409600000",
    "number": "1841889128",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6424 E BROADWAY RD STE 102",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852061750",
            "telephone_number": "480-634-4606"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6424 E BROADWAY RD STE 102",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852061750",
            "telephone_number": "480-634-4606"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ADVANTAGE SURGERY CENTER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-01-12",
        "last_updated": "2021-01-12",
        "certification_date": "2021-01-12",
        "status": "A",
        "authorized_official_last_name": "HERNANDEZ",
        "authorized_official_first_name": "BRANDIE",
        "authorized_official_title_or_position": "DIRECTOR OF OPERATIONS",
        "authorized_official_telephone_number": "480-634-4606"
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Advantage Surgery Center, LLC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Ambulatory Surgical Clinic/Center in Mesa, AZ
• Providers in Mesa, AZ by specialty
• Ambulatory Surgical Clinic/Center in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 12, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
• 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.