Hazleton Surgery Center, LLC

Primary specialty

Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X

Legal business name

HAZLETON SURGERY CENTER, LLC

Practice address

50 Moisey Drive
Suite 100
Hazleton, PA 18202-9297

Phone

(570) 501-6500

NPI assigned

Aug 20, 2006

Organization subpart

No

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

Authorized official

Name

Jonathan Bailey

Title

Officer, Medicare Authorized Offici

Phone

(203) 609-1168

Specialties & licenses 2

Addresses

Other names 1

• Hazleton Surgery Center LLC Former legal business name

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in PA

Enrollment records 1

Listed as

Hazleton Surgery Center LLCCCN 39C0001239

Medicare certification status

ActiveFrom the Provider of Services file

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

CLIA laboratory certificates

Locations

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

{
    "created_epoch": "1156032000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1728432000000",
    "number": "1851406821",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "50 MOISEY DRIVE",
            "address_2": "SUITE 100",
            "city": "HAZLETON",
            "state": "PA",
            "postal_code": "182029297",
            "telephone_number": "570-501-6500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "50 MOISEY DRIVE",
            "address_2": "SUITE 100",
            "city": "HAZLETON",
            "state": "PA",
            "postal_code": "182029297",
            "telephone_number": "570-501-6500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HAZLETON SURGERY CENTER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-20",
        "last_updated": "2024-10-09",
        "certification_date": "2024-10-09",
        "status": "A",
        "authorized_official_last_name": "BAILEY",
        "authorized_official_first_name": "JONATHAN",
        "authorized_official_title_or_position": "OFFICER, MEDICARE AUTHORIZED OFFICI",
        "authorized_official_telephone_number": "203-609-1168"
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://esmd.abilitynetwork.com:8291/gateway/documentsubmission/2_0/NhinService/XDRRequest_Service",
            "affiliation": "Y",
            "endpointDescription": "2.16.840.1.113883.3.667.2",
            "affiliationName": "Ability Network",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "CMS esMD eMDR",
            "address_1": "100 N 6th St Ste 900A",
            "city": "Minneapolis",
            "state": "MN",
            "country_code": "US",
            "postal_code": "554031516",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Hazleton Surgery Center LLC",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

• Hazleton Medical Practice LLC
• Hazleton Oxygen Medical Equipment Inc.
• Hazleton Pathology PC
• Hazleton Professional Services (Lehigh Valley Physician Group-Hazleton)
• Hazleton Radiology Associates
• Health Care Management Group Inc.
• David Scott Heckman, D.D.S.
• Emily Heller
• Jayden Hensley, PHARMD
• Jason Dean Higgins, MSPT

• Ambulatory Surgical Clinic/Center in Hazleton, PA
• Providers in Hazleton, PA by specialty
• Ambulatory Surgical Clinic/Center in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 9, 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.