NPIMap

Organization Active NPI

Redmond Ambulatory Surgery Center, LLC

  • Ambulatory Surgical Clinic/Center
  • Redmond, WA
National Provider Identifier
1871033878
Registry record updated May 16, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X
License
603570646 Issued in WA
Legal business name
REDMOND AMBULATORY SURGERY CENTER, LLC
Practice address
18100 NE Union Hill Rd Ste 340
Redmond, WA 98052
Phone
(425) 507-0767
NPI assigned
Feb 24, 2017
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 16, 2025

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

Authorized official

Name
Mr. Donald Wayne Anderson Jr.
Title
Assistant Secretary for Enrollments
Phone
(425) 358-9786

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ambulatory Surgical Clinic/Center 261QA1903X 603570646 WA Primary

Addresses

Primary practice location

18100 NE Union Hill Rd Ste 340
Redmond, WA 98052

Mailing address

PO Box 920024
Dallas, TX 75392-0024

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20180801000399 WA Part B Supplier - Ambulatory Surgical Center 3870841240 Practice locations: Redmond, WA

Ambulatory surgical center certification: CCN 50C0001324

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
REDMOND AMBULATORY SURGERY CENTER
Certification status
Active
Provider type (POS)
Ambulatory surgical center
Participating since
Nov 7, 2018
Last certification
Nov 7, 2018
Ownership / control type
Non-Profit
Facility address
18100 NE Union Hill Rd Ste 340
Redmond, WA 98052

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
50D2145190Redmond Ambulatory Surgery Center18100 NE Union Hill Rd Ste 340, Redmond, WA 98052Certificate of waiverApr 4, 2028

National Provider Directory

National Provider Directory

Member of 2

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

Locations

18100 NE Union Hill Rd
#340
Redmond, WA 98052
Phone (425) 507-0767

NPI Registry JSON

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

{
    "created_epoch": "1487894400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1747353600000",
    "number": "1871033878",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 920024",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "753920024"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18100 NE UNION HILL RD STE 340",
            "city": "REDMOND",
            "state": "WA",
            "postal_code": "98052",
            "telephone_number": "425-507-0767"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "REDMOND AMBULATORY SURGERY CENTER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-02-24",
        "last_updated": "2025-05-16",
        "certification_date": "2025-05-16",
        "status": "A",
        "authorized_official_last_name": "ANDERSON",
        "authorized_official_first_name": "DONALD",
        "authorized_official_middle_name": "WAYNE",
        "authorized_official_title_or_position": "ASSISTANT SECRETARY FOR ENROLLMENTS",
        "authorized_official_telephone_number": "425-358-9786",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_name_suffix": "Jr."
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": "WA",
            "license": "603570646",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Redmond, WA

Sources for this page

Verify at the official NPI Registry.