Pekosc LLC

Primary specialty

Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X

Legal business name

PEKOSC LLC

Practice address

7634 W Central Ave
Toledo, OH 43617-1526

Phone

(567) 408-7356

NPI assigned

Dec 8, 2021

Organization subpart

No

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

Authorized official

Name

Mark Stutler

Title

Cfo

Phone

(419) 290-3034

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in OH

Enrollment records 1

Ambulatory surgical center certification: CCN 36C0001352

Legal name

Pekosc, LLC

Certification status

Active

Provider type (POS)

Ambulatory surgical center

Participating since

May 25, 2023

Last certification

Mar 21, 2023

Ownership / control type

Proprietary

Facility address

7634 West Central Avenue
Toledo, OH 43617

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

CLIA laboratory certificates

Practitioners 1

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

• Peter F Koltz, MD

  • Plastic Surgery Physician
  • Toledo, OH
  • NPI 1316260797
  NPD

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

{
    "created_epoch": "1638921600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1638921600000",
    "number": "1851050736",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7634 W CENTRAL AVE",
            "city": "TOLEDO",
            "state": "OH",
            "postal_code": "436171526",
            "telephone_number": "567-408-7356"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7634 W CENTRAL AVE",
            "city": "TOLEDO",
            "state": "OH",
            "postal_code": "436171526",
            "telephone_number": "567-408-7356"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PEKOSC LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-12-08",
        "last_updated": "2021-12-08",
        "certification_date": "2021-12-08",
        "status": "A",
        "authorized_official_last_name": "STUTLER",
        "authorized_official_first_name": "MARK",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "419-290-3034"
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Korey Peete Sr.
• Michael Joseph Peeters, PHARMD
• Raven Peguese
• Jason James Robert Peisley, DC
• Peko LLC
• Angad Pelia, MD
• Elisha E Pelland, NP
• Helen N Pellerino, LSW
• Mary Pellioni, MD
• Brett S Pelok, DDS

• Ambulatory Surgical Clinic/Center in Toledo, OH
• Providers in Toledo, OH by specialty
• Ambulatory Surgical Clinic/Center in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 8, 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.