Organization Active NPI

New Smyrna Beach Ambulatory Care Center Inc

  • Ambulatory Surgical Clinic/Center
  • New Smyrna Beach, FL
National Provider Identifier
1902853195
Registry record updated Jun 26, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X
License
1017 Issued in FL
Legal business name
NEW SMYRNA BEACH AMBULATORY CARE CENTER INC
Practice address
612 Palmetto St
New Smyrna Beach, FL 32168-7327
Phone
(386) 423-5500
NPI assigned
May 31, 2006
Last updated
Jun 26, 2014By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 26, 2014

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

Authorized official

Name
Dr. Mark NagraniNPI 1699717611
Title
Medical Director
Phone
(386) 423-5500

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 1017 FL Primary

Addresses

Primary practice location

612 Palmetto St
New Smyrna Beach, FL 32168-7327

Mailing address

612 Palmetto St
New Smyrna Beach, FL 32168-7327
Phone (386) 423-5500

Other identifiers 1

IdentifierTypeStateIssuer
079118100MedicaidFL

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20120213000787 FL Part B Supplier - Ambulatory Surgical Center 8729113113 Practice locations: New Smyrna Beach, FL

Care Compare: Ambulatory surgical center

Medicare Care Compare
Listed as
New Smyrna Beach Ambulatory Care Center IncCCN 10C0001180
Medicare certification status
ActiveFrom the Provider of Services file

National Provider Directory

National Provider Directory
Tax ID family
New Smyrna Beach Ambulatory Care Center2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Member organizations 1

Organizations listed as members of this organization in the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1149033600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1403740800000",
    "number": "1902853195",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "612 PALMETTO ST",
            "city": "NEW SMYRNA BEACH",
            "state": "FL",
            "postal_code": "321687327",
            "telephone_number": "386-423-5500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "612 PALMETTO ST",
            "city": "NEW SMYRNA BEACH",
            "state": "FL",
            "postal_code": "321687327",
            "telephone_number": "386-423-5500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NEW SMYRNA BEACH AMBULATORY CARE CENTER INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-31",
        "last_updated": "2014-06-26",
        "status": "A",
        "authorized_official_last_name": "NAGRANI",
        "authorized_official_first_name": "MARK",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "386-423-5500",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": "FL",
            "license": "1017",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "079118100",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in New Smyrna Beach, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 26, 2014; 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.