NPIMap

Organization Active NPI

Surgery Center at Regency Park, LLC

  • Ambulatory Surgical Clinic/Center
  • Toledo, OH
National Provider Identifier
1871574145
Registry record updated Jun 19, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X
License
0091AS Issued in OH
Legal business name
SURGERY CENTER AT REGENCY PARK, LLC
Practice address
2000 Regency CT Ste 101
Toledo, OH 43623-3075
Phone
(419) 882-0003
Fax
(419) 882-2195
NPI assigned
Nov 14, 2005
Last updated
Jun 19, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 19, 2008

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

Authorized official

Name
Rosa M. Perez
Title
Business Office Manger
Phone
(419) 882-0003

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ambulatory Surgical Clinic/Center 261QA1903X 0091AS OH Primary

Addresses

Primary practice location

2000 Regency CT Ste 101
Toledo, OH 43623-3075

Mailing address

2000 Regency CT Ste 101
Toledo, OH 43623-3075
Phone (419) 882-0003

Other identifiers 1

IdentifierTypeStateIssuer
2049269MedicaidOH

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20180426000915 OH Part B Supplier - Ambulatory Surgical Center 1658363775 Practice locations: Toledo, OH

Care Compare: Ambulatory surgical center

Medicare Care Compare
Listed as
Surgery Center at Regency Park LLCCCN 36C0001090
Medicare certification status
Terminated Voluntary: merger or closure, Mar 30, 2015From the Provider of Services file

Care Compare: Ambulatory surgical center

Medicare Care Compare
Listed as
Surgery Center at Regency ParkCCN 36C0001307
Medicare certification status
ActiveFrom the Provider of Services file

National Provider Directory

National Provider Directory

Locations

2000 Regency Ct
Ste 101
Toledo, OH 43623
Phone (419) 720-7866

Practitioners & affiliated clinicians

Practitioners 20

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.

View all 20

NPI Registry JSON

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

{
    "created_epoch": "1131926400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1213833600000",
    "number": "1871574145",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2000 REGENCY CT STE 101",
            "city": "TOLEDO",
            "state": "OH",
            "postal_code": "436233075",
            "telephone_number": "419-882-0003",
            "fax_number": "419-882-2195"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2000 REGENCY CT STE 101",
            "city": "TOLEDO",
            "state": "OH",
            "postal_code": "436233075",
            "telephone_number": "419-882-0003",
            "fax_number": "419-882-2195"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SURGERY CENTER AT REGENCY PARK, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-11-14",
        "last_updated": "2008-06-19",
        "status": "A",
        "authorized_official_last_name": "PEREZ",
        "authorized_official_first_name": "ROSA",
        "authorized_official_middle_name": "M.",
        "authorized_official_title_or_position": "BUSINESS OFFICE MANGER",
        "authorized_official_telephone_number": "419-882-0003"
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": "OH",
            "license": "0091AS",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2049269",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Toledo, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 19, 2008; 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.