NPIMap

Organization Active NPI

Premier Surgical Suites, LLC

  • Ambulatory Surgical Clinic/Center
  • Clearwater, FL
National Provider Identifier
1851006316
Registry record updated Jun 27, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X
Legal business name
PREMIER SURGICAL SUITES, LLC
Practice address
2111 Drew St Ste 100
Clearwater, FL 33765-3215
Phone
(727) 604-5090
Fax
(727) 442-1600
NPI assigned
Jan 19, 2023
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 27, 2023

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

Authorized official

Name
Dr. Ginger Urbaniak, MDNPI 1124448014
Title
Cfo
Phone
(616) 218-4495

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Plastic Surgery PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208200000X
Ambulatory Surgical Clinic/Center 261QA1903X Primary

Addresses

Primary practice location

2111 Drew St Ste 100
Clearwater, FL 33765-3215

Mailing address

2111 Drew St Ste 100
Clearwater, FL 33765-3215
Phone (727) 604-5090

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20230710001362 FL Part B Supplier - Ambulatory Surgical Center 3577922582 Receives reassigned benefits from 5 practitioners
Practice locations: Clearwater, FL

Ambulatory surgical center certification: CCN 10C0001729

Name & address match This certification has no NPI in the Medicare enrollment files. CMS publishes enrollment files for six facility types only, so it was connected to this NPI by matching the name and address CMS publishes for it.

Legal name
PREMIER SURGICAL SUITES
Certification status
Active
Provider type (POS)
Ambulatory surgical center
Participating since
Sep 25, 2023
Last certification
Sep 25, 2023
Ownership / control type
Proprietary
Facility address
2111 Drew St, Ste 100
Clearwater, FL 33765

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
10D2276448Premier Surgical Suites LLC2111 Drew Street Suite 100, Clearwater, FL 33765Certificate of waiverFeb 7, 2027

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 7

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1674086400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1687824000000",
    "number": "1851006316",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2111 DREW ST STE 100",
            "city": "CLEARWATER",
            "state": "FL",
            "postal_code": "337653215",
            "telephone_number": "727-604-5090",
            "fax_number": "727-442-1600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2111 DREW ST STE 100",
            "city": "CLEARWATER",
            "state": "FL",
            "postal_code": "337653215",
            "telephone_number": "727-604-5090",
            "fax_number": "727-442-1600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PREMIER SURGICAL SUITES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-01-19",
        "last_updated": "2023-06-27",
        "certification_date": "2023-06-27",
        "status": "A",
        "authorized_official_last_name": "URBANIAK",
        "authorized_official_first_name": "GINGER",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "616-218-4495",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208200000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Plastic Surgery",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Clearwater, FL

Sources for this page

Verify at the official NPI Registry.