Lake Pleasant Surgical Center LLC

Primary specialty

Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X

Legal business name

LAKE PLEASANT SURGICAL CENTER LLC

Practice address

15601 N 28TH Ave Ste 101
Phoenix, AZ 85053-4061

Phone

(602) 237-6340

NPI assigned

Oct 5, 2020

Organization subpart

No

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

Authorized official

Name

Thomas MoshiriNPI 1487628442

Title

Manager

Phone

(602) 441-3573

Specialties & licenses 1

Addresses

Locations

Practitioners 2

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.

• Thomas M Moshiri, MD

  • Interventional Pain Medicine Physician
  • Phoenix, AZ
  • NPI 1487628442
  Authorized official Same address or phone
• Jason Richard Jensen, M.D.

  • Pain Medicine Physician
  • Scottsdale, AZ
  • NPI 1871715367
  NPD

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

{
    "created_epoch": "1601856000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1645660800000",
    "number": "1902403736",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10810 N TATUM BLVD STE 102-855",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850286055"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15601 N 28TH AVE STE 101",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850534061",
            "telephone_number": "602-237-6340"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LAKE PLEASANT SURGICAL CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-10-05",
        "last_updated": "2022-02-24",
        "certification_date": "2022-02-24",
        "status": "A",
        "authorized_official_last_name": "MOSHIRI",
        "authorized_official_first_name": "THOMAS",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "602-441-3573"
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Matthew Dean Laird, PMHNP-BC
• Jeffrey A Laiserin, M.D.
• Steven P Laitin, M.D.
• Danielle Lucie Lajeunesse, DC
• Lake Mi Mobile Doctors, P.C. (Mobile Doctors of Phoenix)
• Herbert Vincent Lake, D.C.
• Melissa Lake, LAC
• Melissa Ann Lake, PSY.D.
• Warren James Lake, P.T.
• Briana Danyelle Lakebrink, ATC, ITAT

• 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 Feb 24, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.