Centennial Surgunit, LLC

Primary specialty

Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X

License

22835 Issued in NJ

Legal business name

CENTENNIAL SURGUNIT, LLC

Practice address

502 Centennial Blvd
Suite 1
Voorhees, NJ 08043-9544

Phone

(856) 874-0790

Fax

(856) 751-0349

NPI assigned

Aug 15, 2005

Organization subpart

No

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

Authorized official

Name

Mr. Stephen Barainyak

Title

Executive Director

Phone

(856) 874-0790

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Centennial Surgery Center Doing business as

Medicare fee-for-service enrollment

Enrolled in NJ

Enrollment records 1

Listed as

Centennial Surgery CenterCCN 31C0001123

Medicare certification status

ActiveFrom the Provider of Services file

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

• Virtua Our Lady of Lourdes Hospital Inc

  • General Acute Care Hospital
  • Camden, NJ
  • NPI 1235134024

  Member Of

  NPD member

Locations

Practitioners 2

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

• Randy B Ackerman, MD

  • Urology Physician
  • Cherry Hill, NJ
  • NPI 1205893807
  NPD
• Jay M Malamut, M.D.

  • Gastroenterology Physician
  • Haddon Heights, NJ
  • NPI 1881682367
  NPD

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

{
    "created_epoch": "1124064000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1409011200000",
    "number": "1912909433",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "502 CENTENNIAL BLVD",
            "address_2": "SUITE 1",
            "city": "VOORHEES",
            "state": "NJ",
            "postal_code": "080439544",
            "telephone_number": "856-874-0790",
            "fax_number": "856-751-0349"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "502 CENTENNIAL BLVD",
            "address_2": "SUITE 1",
            "city": "VOORHEES",
            "state": "NJ",
            "postal_code": "080439544",
            "telephone_number": "856-874-0790",
            "fax_number": "856-751-0349"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CENTENNIAL SURGUNIT, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-08-15",
        "last_updated": "2014-08-26",
        "status": "A",
        "authorized_official_last_name": "BARAINYAK",
        "authorized_official_first_name": "STEPHEN",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "856-874-0790",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": "NJ",
            "license": "22835",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8084009",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Centennial Surgery Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Catherine P Montgomery, MD, LLC
• Christine Marie Catts, NNP
• Cavallaro Family Practice
• Alex M Celluzzi, DO
• Centennial Surgunit, LLC
• Center for Family Services
• Center for Family Services
• Center for Family Services
• Center for Family Services, Inc.
• Center for Family Services, Inc.

• All providers in Voorhees, NJ
• Ambulatory Surgical Clinic/Center in New Jersey

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