Restorative Surgery Center LLC

Primary specialty

Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X

Legal business name

RESTORATIVE SURGERY CENTER LLC

Practice address

6829 Parker Rd Ste B
Florissant, MO 63033-5308

Phone

(314) 741-2700

Fax

(314) 741-2701

NPI assigned

Aug 6, 2020

Organization subpart

No

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

Authorized official

Name

Gregory A Stynowick, MDNPI 1437256542

Title

Medical Director

Phone

(314) 741-2700

Specialties & licenses 1

Addresses

Other names 3

• IPS Surgery Center, LLC Former legal business name
• Restorative Surgery Center Former legal business name
• Restorative Surgery Center, LLC Former legal business name

Medicare fee-for-service enrollment

Enrolled in MO

Enrollment records 1

Listed as

Restorative Surgery Center LLCCCN 26C0001174

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 3

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

• Gregory A Stynowick, MD

  • Pain Medicine Physician
  • Florissant, MO
  • NPI 1437256542
  NPD Authorized official
• Ryan Harris, FNP-C

  • Family Nurse Practitioner
  • Fenton, MO
  • NPI 1285228213
  NPD
• Souheil F. Haddad, M.D.

  • Specialist
  • Bloomington, IN
  • NPI 1659355931
  NPD

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

{
    "created_epoch": "1596672000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1622505600000",
    "number": "1932719754",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6829 PARKER RD STE B",
            "city": "FLORISSANT",
            "state": "MO",
            "postal_code": "630335308",
            "telephone_number": "314-741-2700",
            "fax_number": "314-741-2701"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6829 PARKER RD STE B",
            "city": "FLORISSANT",
            "state": "MO",
            "postal_code": "630335308",
            "telephone_number": "314-741-2700",
            "fax_number": "314-741-2701"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RESTORATIVE SURGERY CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-08-06",
        "last_updated": "2021-06-01",
        "certification_date": "2021-06-01",
        "status": "A",
        "authorized_official_last_name": "STYNOWICK",
        "authorized_official_first_name": "GREGORY",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "314-741-2700",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "IPS Surgery Center, LLC",
            "code": "4",
            "type": "Former Legal Business Name"
        },
        {
            "organization_name": "IPS Surgery Center, LLC",
            "code": "4",
            "type": "Former Legal Business Name"
        },
        {
            "organization_name": "Restorative Surgery Center",
            "code": "4",
            "type": "Former Legal Business Name"
        },
        {
            "organization_name": "Restorative Surgery Center, LLC",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

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• Ambulatory Surgical Clinic/Center in Florissant, MO
• Providers in Florissant, MO by specialty
• Ambulatory Surgical Clinic/Center in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 1, 2021; 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.