Outpatient Surgery Center, Inc

Primary specialty

Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X

License

1166 Issued in FL

Legal business name

OUTPATIENT SURGERY CENTER, INC

Practice address

5193 Mariner Blvd
Suite B
Spring Hill, FL 34609-1834

Phone

(352) 688-6393

Fax

(352) 688-1113

NPI assigned

Jul 7, 2006

Organization subpart

Yes

Parent organization

OUTPATIENT SURGERY CENTER, INC.As reported in NPPES

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

Authorized official

Name

Dr. George S Sidhom, MD

Title

Medical Director

Phone

(352) 688-6393

Specialties & licenses 1

Addresses

Other names 1

• Mariner Surgery Center Doing business as

Medicare fee-for-service enrollment

Enrolled in FL2 enrollments

Enrollment records 2

Ambulatory surgical center certification: CCN 10C0001386

Legal name

MARINER SURGERY CENTER

Certification status

Active

Provider type (POS)

Ambulatory surgical center

Participating since

Feb 7, 2003

Last certification

Aug 26, 2020

Ownership / control type

Proprietary

Facility address

5193 Mariner Blvd
Spring Hill, FL 34609

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

• Outpatient Surgery Center Inc

  • Ambulatory Surgical Clinic/Center
  • Brandon, FL
  • NPI 1619049269

  5597769141

  Same PAC ID

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

• Outpatient Surgery Center Inc

  • Ambulatory Surgical Clinic/Center
  • Brandon, FL
  • NPI 1619049269

  O20060913000135

  Same enrollment

Part of

Outpatient Surgery Center Inc

Locations

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

{
    "created_epoch": "1152230400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1265932800000",
    "number": "1902838402",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5193 MARINER BLVD",
            "address_2": "SUITE B",
            "city": "SPRING HILL",
            "state": "FL",
            "postal_code": "346091834",
            "telephone_number": "352-688-6393",
            "fax_number": "352-688-1113"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5193 MARINER BLVD",
            "address_2": "SUITE B",
            "city": "SPRING HILL",
            "state": "FL",
            "postal_code": "346091834",
            "telephone_number": "352-688-6393",
            "fax_number": "352-688-1113"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OUTPATIENT SURGERY CENTER, INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "OUTPATIENT SURGERY CENTER, INC.",
        "enumeration_date": "2006-07-07",
        "last_updated": "2010-02-12",
        "status": "A",
        "authorized_official_last_name": "SIDHOM",
        "authorized_official_first_name": "GEORGE",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "352-688-6393",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": "FL",
            "license": "1166",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Mariner Surgery Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Laksmy Marcela Ossaba-Quiroz, M.S.
• Osteopathic Heritage, P.a.
• Brian P Osullivan, DMD
• Kevin L Ottoson, LDO
• Ousia Pharmacy Corp
• Kristine Overcash, PTA
• Alex Padikken
• Michel Esteban Padron Perez
• Liana Maria Paez Cruz
• Lisa Stern Paine, A.R.N.P.

• Ambulatory Surgical Clinic/Center in Spring Hill, FL
• Providers in Spring Hill, FL by specialty
• Ambulatory Surgical Clinic/Center in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 12, 2010; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.