Organization Active NPI

Plattsburgh ASC LLC

  • Ambulatory Surgical Clinic/Center
  • Plattsburgh, NY
National Provider Identifier
1891784955
Registry record updated Jul 5, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X
Legal business name
PLATTSBURGH ASC LLC
Practice address
450 Margaret St
Plattsburgh, NY 12901-1755
Phone
(518) 561-3144
Fax
(518) 561-3155
NPI assigned
Oct 20, 2005
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 5, 2010

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

Authorized official

Name
Mr. Kjell Dahlen, MDNPI 1568451912
Title
President
Phone
(518) 561-3144

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

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

Addresses

Primary practice location

450 Margaret St
Plattsburgh, NY 12901-1755

Mailing address

450 Margaret St
Plattsburgh, NY 12901-1755
Phone (518) 561-3144

Other identifiers 1

IdentifierTypeStateIssuer
02045274MedicaidNY

Other names 1

  • Cataract Cetner for the Adirondacks Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040505000974 NY Part B Supplier - Ambulatory Surgical Center 4688662877 Receives reassigned benefits from 2 practitioners
Practice locations: Plattsburgh, NY

Care Compare: Ambulatory surgical center

Medicare Care Compare
Listed as
Cataract Center for the AdirondacksCCN 33C0001046
Medicare certification status
ActiveFrom the Provider of Services file

National Provider Directory

National Provider Directory

Locations

450 Margaret St
Ste 2
Plattsburgh, NY 12901

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1129766400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1278288000000",
    "number": "1891784955",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "450 MARGARET ST",
            "city": "PLATTSBURGH",
            "state": "NY",
            "postal_code": "129011755",
            "telephone_number": "518-561-3144",
            "fax_number": "518-561-3155"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "450 MARGARET ST",
            "city": "PLATTSBURGH",
            "state": "NY",
            "postal_code": "129011755",
            "telephone_number": "518-561-3144",
            "fax_number": "518-561-3155"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PLATTSBURGH ASC LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-10-20",
        "last_updated": "2010-07-05",
        "status": "A",
        "authorized_official_last_name": "DAHLEN",
        "authorized_official_first_name": "KJELL",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "518-561-3144",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02045274",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Cataract Cetner for the Adirondacks",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Plattsburgh, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 5, 2010; 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.