Squaw Peak Surgical Facility Inc

Primary specialty

Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X

License

OSC1965 Issued in AZ

Legal business name

SQUAW PEAK SURGICAL FACILITY INC

Practice address

1635 E Myrtle #100
Phoenix, AZ 85020-0000

Phone

(602) 944-5656

Fax

(602) 944-2727

NPI assigned

Jul 21, 2006

Last updated

Jul 7, 2022By 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

Anthony T Yeung, MD

Title

President

Phone

(602) 944-5656

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in AZ

Enrollment records 1

Listed as

Squaw Peak Surgical Facility IncCCN 03C0001220

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

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Joshua Abrams, DO

  • Orthopaedic Surgery of the Spine Physician
  • Phoenix, AZ
  • NPI 1649482084
  NPD (past)

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

{
    "created_epoch": "1153440000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1657152000000",
    "number": "1871513705",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1635 E MYRTLE #100",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850200000",
            "telephone_number": "602-944-5656",
            "fax_number": "602-944-2727"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1635 E MYRTLE #100",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850200000",
            "telephone_number": "602-944-5656",
            "fax_number": "602-944-2727"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SQUAW PEAK SURGICAL FACILITY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-21",
        "last_updated": "2022-07-07",
        "certification_date": "2022-07-07",
        "status": "A",
        "authorized_official_last_name": "YEUNG",
        "authorized_official_first_name": "ANTHONY",
        "authorized_official_middle_name": "T",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "602-944-5656",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": "AZ",
            "license": "OSC1965",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Square Triangle LLC
• Square Triangle LLC
• Square Triangle LLC
• Squared Affairs Inc.
• Squaw Peak Family Physicians PC
• Alisa Squires
• Michael Trevor Sramek, MD
• SRCV Haven, LLC (Desert Haven Care Center)
• Mohana Krishnan Sridhar, M.D.,
• Shreya Sridhar

• Ambulatory Surgical Clinic/Center in Phoenix, AZ
• Providers in Phoenix, AZ by specialty
• Ambulatory Surgical Clinic/Center in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 7, 2022; 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.