NPIMap

Organization Active NPI

Garden State Surgical Center, LLC

  • Ambulatory Surgical Clinic/Center
  • Fair Lawn, NJ
National Provider Identifier
1891882031
Registry record updated Jan 10, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X
Legal business name
GARDEN STATE SURGICAL CENTER, LLC
Practice address
28-06 Broadway
Fair Lawn, NJ 07410-3913
Phone
(201) 475-8940
NPI assigned
Oct 9, 2006
Last updated
Jan 10, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 10, 2025

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

Authorized official

Name
Dr. Kenneth A Levitsky, M.D.NPI 1629045455
Title
Managing Partner
Phone
(201) 475-8940

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

28-06 Broadway
Fair Lawn, NJ 07410-3913

Mailing address

28-06 Broadway
Fair Lawn, NJ 07410-3913
Phone (201) 475-8940

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20100331000391 NJ Part B Supplier - Ambulatory Surgical Center 9234265091 Practice locations: Fair Lawn, NJ

Care Compare: Ambulatory surgical center

Medicare Care Compare
Listed as
Garden State Surgical Center LLCCCN 31C0001089
Medicare certification status
ActiveFrom the Provider of Services file

Laboratory certificates & supplier records

Derived by NPIMap

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

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
31D2042181Garden State Surgical Center, LLC28-06 Broadway, Fair Lawn, NJ 07410Certificate of waiverJun 6, 2028

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 24

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 24

NPI Registry JSON

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

{
    "created_epoch": "1160352000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1736467200000",
    "number": "1891882031",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "28-06 BROADWAY",
            "city": "FAIR LAWN",
            "state": "NJ",
            "postal_code": "074103913",
            "telephone_number": "201-475-8940"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "28-06 BROADWAY",
            "city": "FAIR LAWN",
            "state": "NJ",
            "postal_code": "074103913",
            "telephone_number": "201-475-8940"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GARDEN STATE SURGICAL CENTER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-09",
        "last_updated": "2025-01-10",
        "certification_date": "2025-01-10",
        "status": "A",
        "authorized_official_last_name": "LEVITSKY",
        "authorized_official_first_name": "KENNETH",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "MANAGING PARTNER",
        "authorized_official_telephone_number": "201-475-8940",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fair Lawn, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 10, 2025; 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.