Premium Surgical Services Center

Primary specialty

Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X

License

200969825 Issued in NV

Legal business name

PREMIUM SURGICAL SERVICES CENTER

Practice address

8954 Spanish Ridge Avenue Suite 1
Las Vegas, NV 89148

Phone

(702) 243-9555

Fax

(702) 243-9856

NPI assigned

Sep 28, 2009

Last updated

Feb 9, 2011By 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

Frank L Stile, M.D.NPI 1568540219

Title

Owner/Medical Director

Phone

(702) 243-9555

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NV

Enrollment records 1

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1922332774. Details of each certification follow.

• CCN 29C0001083 Ambulatory surgical center · Active · Name & address match · Details

Ambulatory surgical center certification: CCN 29C0001083

Legal name

PREMIUM SURGICAL SERVICES CENTER

Certification status

Active

Provider type (POS)

Ambulatory surgical center

Participating since

Jan 21, 2011

Last certification

Jan 21, 2011

Ownership / control type

Proprietary

Facility address

8954 Spanish Ridge Ave
Las Vegas, NV 89148

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, and the practitioner matching its NPPES authorized official.

• Frank Louis Stile, MD

  • Plastic Surgery Physician
  • Las Vegas, NV
  • NPI 1568540219
  NPD (past) Authorized official

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

{
    "created_epoch": "1254096000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1297209600000",
    "number": "1922332774",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8954 SPANISH RIDGE AVE SUITE 2",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "89148",
            "telephone_number": "702-221-9374",
            "fax_number": "702-221-9805"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8954 SPANISH RIDGE AVENUE SUITE 1",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "89148",
            "telephone_number": "702-243-9555",
            "fax_number": "702-243-9856"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PREMIUM SURGICAL SERVICES CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-09-28",
        "last_updated": "2011-02-09",
        "status": "A",
        "authorized_official_last_name": "STILE",
        "authorized_official_first_name": "FRANK",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "OWNER/MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "702-243-9555",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": "NV",
            "license": "200969825",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Premise Health of Nevada Medical Hinitt PC (Teamsters 631 Medical Center Durango)
• Premium Health Professionals LLC (Vegas Children's Urgent Care)
• Premium in Home Health Care LLC
• Mario Ivanov Premyanov
• Mercades M Prendes
• Ryan Prendez
• Katie Prentice
• Teairra Marie Prentice

• Ambulatory Surgical Clinic/Center in Las Vegas, NV
• Providers in Las Vegas, NV by specialty
• Ambulatory Surgical Clinic/Center in Nevada

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 9, 2011; 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.
• 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.