BSC Shea Park LLC

Primary specialty

Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X

Legal business name

BSC SHEA PARK LLC

Practice address

4200 E Camelback Rd Ste 101
Phoenix, AZ 85018-2718

Phone

(480) 590-3581

NPI assigned

May 2, 2022

Organization subpart

No

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

Authorized official

Name

Aric Burke

Title

Director/Officer

Phone

(602) 358-8512

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in AZ

Enrollment records 1

Ambulatory surgical center certification: CCN 03C0001470

Legal name

BSC SHEA PARK LLC

Certification status

Active

Provider type (POS)

Ambulatory surgical center

Participating since

Dec 16, 2022

Last certification

Oct 28, 2022

Ownership / control type

Proprietary

Facility address

4200 East Camelback Road Suite 101
Phoenix, AZ 85018

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

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

{
    "created_epoch": "1651449600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1747094400000",
    "number": "1881339133",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4200 E CAMELBACK RD STE 101",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850182718",
            "telephone_number": "480-590-3581"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4200 E CAMELBACK RD STE 101",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850182718",
            "telephone_number": "480-590-3581"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BSC SHEA PARK LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-05-02",
        "last_updated": "2025-05-13",
        "certification_date": "2025-04-15",
        "status": "A",
        "authorized_official_last_name": "BURKE",
        "authorized_official_first_name": "ARIC",
        "authorized_official_title_or_position": "DIRECTOR/OFFICER",
        "authorized_official_telephone_number": "602-358-8512"
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Merima Bucaj, D.O.
• Aimee Susanne Bucci, P.N.P.
• Kinnari Buch, MD
• Nicole Buchak

• 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 May 13, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
• 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.