NPIMap

Organization Active NPI

Heart and Vascular Surgical Center, LLC

  • Ambulatory Surgical Clinic/Center
  • Mesa, AZ
National Provider Identifier
1881074102
Registry record updated Mar 15, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X
Legal business name
HEART AND VASCULAR SURGICAL CENTER, LLC
Practice address
4860 E Baseline Rd
Suite 102
Mesa, AZ 85206-4669
Phone
(480) 772-0575
Fax
(844) 836-4859
NPI assigned
Jun 2, 2015
Last updated
Mar 15, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 15, 2021

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

Authorized official

Name
Ms. Cheryl Elaine Bonelli
Title
Administrator
Phone
(480) 772-0575

Specialties & licenses 1

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

Addresses

Primary practice location

4860 E Baseline Rd
Suite 102
Mesa, AZ 85206-4669

Mailing address

4860 E Baseline Rd Ste 102
Mesa, AZ 85206-4670
Phone (480) 772-0575

Other names 1

  • Chan Heart Rhythm Institute Surgical Treatment Center, LLC Former legal business name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1881074102. Details of each certification follow.

Ambulatory surgical center certification: CCN 03C0001374

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
HEART AND VASCULAR SURGICAL CENTER, LLC
Certification status
Active
Provider type (POS)
Ambulatory surgical center
Participating since
Mar 5, 2017
Last certification
Mar 6, 2020
Ownership / control type
Proprietary
Facility address
4860 East Baseline Road, Suite 102
Mesa, AZ 85206

National Provider Directory

National Provider Directory

Member of 1

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

Locations

1955 W Baseline Rd
Ste 113141
Mesa, AZ 85202

NPI Registry JSON

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

{
    "created_epoch": "1433203200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1615766400000",
    "number": "1881074102",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4860 E BASELINE RD STE 102",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852064670",
            "telephone_number": "480-772-0575",
            "fax_number": "844-836-4859"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4860 E BASELINE RD",
            "address_2": "SUITE 102",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852064669",
            "telephone_number": "480-772-0575",
            "fax_number": "844-836-4859"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HEART AND VASCULAR SURGICAL CENTER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-06-02",
        "last_updated": "2021-03-15",
        "certification_date": "2021-03-15",
        "status": "A",
        "authorized_official_last_name": "BONELLI",
        "authorized_official_first_name": "CHERYL",
        "authorized_official_middle_name": "ELAINE",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "480-772-0575",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Chan Heart Rhythm Institute Surgical Treatment Center, LLC",
            "code": "4",
            "type": "Former Legal Business Name"
        },
        {
            "organization_name": "Chan Heart Rhythm Institute Surgical Treatment Center, LLC",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in Mesa, AZ

Sources for this page

Verify at the official NPI Registry.