Crystal Run Ambulatory Surgery Center of Middletown, LLC

Primary specialty

Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X

Legal business name

CRYSTAL RUN AMBULATORY SURGERY CENTER OF MIDDLETOWN, LLC

Practice address

95 Crystal Run Rd
Middletown, NY 10941-7001

Phone

(845) 703-6999

Fax

(845) 703-6297

NPI assigned

Aug 11, 2009

Last updated

Feb 17, 2025By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

David Ortiz

Title

Administrator

Phone

(845) 703-3800

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in NY

Enrollment records 1

Listed as

Crystal Run Ambulatory SurgeryCCN 33C0001109

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

Practitioners 4

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.

• Jonathan Nasser, MD

  • Internal Medicine Physician
  • Middletown, NY
  • NPI 1194713347
  NPD
• Deborah K. Spencer, M.D.

  • Obstetrics & Gynecology Physician
  • Middletown, NY
  • NPI 1952383069
  NPD
• Hal David Teitelbaum, MD, MBA

  • Internal Medicine Physician
  • Rock Hill, NY
  • NPI 1720070204
  NPD
• V. Christopher Inzerillo, M.D.

  • Sports Medicine (Orthopaedic Surgery) Physician
  • Paramus, NJ
  • NPI 1578546735
  NPD (past)

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

{
    "created_epoch": "1249948800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1739750400000",
    "number": "1922230853",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "95 CRYSTAL RUN RD",
            "city": "MIDDLETOWN",
            "state": "NY",
            "postal_code": "109417001",
            "telephone_number": "845-703-6999",
            "fax_number": "845-703-6297"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "95 CRYSTAL RUN RD",
            "city": "MIDDLETOWN",
            "state": "NY",
            "postal_code": "109417001",
            "telephone_number": "845-703-6999",
            "fax_number": "845-703-6297"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CRYSTAL RUN AMBULATORY SURGERY CENTER OF MIDDLETOWN, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-08-11",
        "last_updated": "2025-02-17",
        "certification_date": "2025-02-17",
        "status": "A",
        "authorized_official_last_name": "ORTIZ",
        "authorized_official_first_name": "DAVID",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "845-703-3800"
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": "NY",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "03240397",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Laura K Cruz, DC
• Michelle Cruz, LP
• Natalie Ann Cruz
• Pavel Cruz, FNP-BC
• Crystal Clear Vision Corp.
• Crystal Run Healthcare LLP
• Crystal Run Healthcare Physicians LLP
• Crystal Run Healthcare Physicians LLP
• Crystal Run Healthcare Physicians LLP
• Crystal Run Healthcare Physicians LLP

• Ambulatory Surgical Clinic/Center in Middletown, NY
• Providers in Middletown, NY by specialty
• Ambulatory Surgical Clinic/Center in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 17, 2025; 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.