Adventhealth Surgery Center Mills Park LLC

Primary specialty

Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X

Legal business name

ADVENTHEALTH SURGERY CENTER MILLS PARK LLC

Doing business as

AdventHealth Surgery Center Mills Park

Practice address

1812 N Mills Ave Ste 210
Orlando, FL 32803-1834

Phone

(407) 420-0100

Fax

(407) 420-0083

NPI assigned

Apr 5, 2021

Last updated

Sep 6, 2024By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Collin Lemaistre

Title

Officer/Authorized Official

Phone

(214) 213-0732

Specialties & licenses 1

Addresses

Other names 1

• AdventHealth Surgery Center Mills Park Doing business as

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

Listed as

Adventhealth Surgery Center Mills Park LLCCCN 10C0001709

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

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

• Baylor University Medical Center

  • General Acute Care Hospital
  • Dallas, TX
  • NPI 1447250253

  Member Of

  NPD member

Locations

Networks

• Freedom Health HMO NetworkPlans: Freedom Platinum Rewards Plan Rx (HMO) (H5427-102-000, H5427); Freedom VIP Care (HMO C-SNP) (H5427-070-000, H5427); Freedom VIP Rewards (HMO C-SNP) (H5427-108-000, H5427); Freedom VIP Rewards (HMO C-SNP) (H5427-099-000, H5427); Freedom Platinum Rewards Plan Rx (HMO) (H5427-107-000, H5427); Freedom Máximo (HMO-POS) (H5427-113-000, H5427); Freedom Savings Plan (HMO) (H5427-052-000, H5427); Freedom Platinum Rewards Plan Rx (HMO) (H5427-096-000, H5427); Freedom Platinum Rewards Plan Rx (HMO) (H5427-105-000, H5427); Freedom Medi-Medi Full (HMO D-SNP) (H5427-087-000, H5427)…
• Optimum HealthCare HMO NetworkPlans: Optimum Diamond Rewards (HMO C-SNP) (H5594-028-000, H5594); Optimum Diamond (HMO C-SNP) (H5594-036-000, H5594); Optimum Diamond Rewards (HMO C-SNP) (H5594-034-000, H5594); Optimum Diamond Rewards COPD (HMO C-SNP) (H5594-029-000, H5594); Optimum Platinum Plan (HMO) (H5594-002-000, H5594); Optimum Gold Plus Plan (HMO) (H5594-032-000, H5594); Optimum Diamond Savings COPD (HMO C-SNP) (H5594-031-000, H5594); Optimum Diamond Savings (HMO C-SNP) (H5594-030-000, H5594); Optimum Diamond Rewards COPD (HMO C-SNP) (H5594-035-000, H5594)

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

{
    "created_epoch": "1617580800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1725580800000",
    "number": "1861071250",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1812 N MILLS AVE STE 210",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328031834",
            "telephone_number": "407-420-0100",
            "fax_number": "407-286-4420"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1812 N MILLS AVE STE 210",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328031834",
            "telephone_number": "407-420-0100",
            "fax_number": "407-420-0083"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ADVENTHEALTH SURGERY CENTER MILLS PARK LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-04-05",
        "last_updated": "2024-09-06",
        "certification_date": "2024-09-06",
        "status": "A",
        "authorized_official_last_name": "LEMAISTRE",
        "authorized_official_first_name": "COLLIN",
        "authorized_official_title_or_position": "OFFICER/AUTHORIZED OFFICIAL",
        "authorized_official_telephone_number": "214-213-0732"
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "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": "AdventHealth Surgery Center Mills Park",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "AdventHealth Surgery Center Mills Park",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Advent Health
• Advent Healthcare
• Adventhealth Imaging Center Innovation
• Adventhealth Imaging Training Center
• Adventhealth Surgery Center Innovation Tower, LLC
• Adventhealth VC Services LLC
• Adventist Care Centers Courtland Inc (AdventHealth Care Center Orlando North)
• Adventist Health System Sunbelt Inc (Florida Hospital)
• Adventist Health System Sunbelt Inc (Florida Hospital Sports Concussion Program)
• Adventist Health System Sunbelt Inc (The Trina Hidalgo Heart Care Center Orlando)

• Ambulatory Surgical Clinic/Center in Orlando, FL
• Providers in Orlando, FL by specialty
• Ambulatory Surgical Clinic/Center in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 6, 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.