SDM ASC LLC

Primary specialty

Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X

License

007141 Issued in TX

Legal business name

SDM ASC LLC

Practice address

6311 Southwest Blvd
Fort Worth, TX 76132-1063

Phone

(817) 738-3390

Fax

(817) 731-4282

NPI assigned

May 19, 2006

Organization subpart

No

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

Authorized official

Name

Pam Monaghan, RN

Title

Administrator

Phone

(817) 738-3390

Specialties & licenses 1

Addresses

Other identifiers 3

Other names 1

• Daytime Outpatient Surgery Center Doing business as

Medicare fee-for-service enrollment

Enrolled in TX

Enrollment records 1

Listed as

Daytime Outpatient Surgery CenterCCN 45C0001272

Medicare certification status

ActiveFrom the Provider of Services file

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

Practitioners 1

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

• Joseph Daniels, D.O.

  • Orthopaedic Surgery Physician
  • Fort Worth, TX
  • NPI 1568409571
  NPD (past)

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

{
    "created_epoch": "1147996800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1712793600000",
    "number": "1902850571",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6311 SOUTHWEST BLVD",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761321063",
            "telephone_number": "817-738-3390",
            "fax_number": "817-731-4282"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6311 SOUTHWEST BLVD",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761321063",
            "telephone_number": "817-738-3390",
            "fax_number": "817-731-4282"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SDM ASC LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-19",
        "last_updated": "2024-04-11",
        "certification_date": "2024-04-11",
        "status": "A",
        "authorized_official_last_name": "MONAGHAN",
        "authorized_official_first_name": "PAM",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "817-738-3390",
        "authorized_official_credential": "RN"
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": "TX",
            "license": "007141",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "7418670",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DEPARTMENT OF LABOR",
            "identifier": "181326700",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "HH048A",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Daytime Outpatient Surgery Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Suleyka Macias Scribner
• William B. Scroggie, M.D.
• Thomas Andrew Scully, DO
• Sculpted Body Medspa LLC
• SD Meadowbrook PLLC
• Charles Richard Seaberg Jr., LCDC
• Candace Seagraves, O.D.
• Andrea Christine Seal, LCDC-I
• Alexandra Danielle Seale
• Ashlie Nichole Seale, PMHNP-BC

• Ambulatory Surgical Clinic/Center in Fort Worth, TX
• Providers in Fort Worth, TX by specialty
• Ambulatory Surgical Clinic/Center in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 11, 2024; 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.