NPIMap

Organization Active NPI

Premier Physicians Centers, Inc

  • Ambulatory Surgical Clinic/Center
  • Westlake, OH
National Provider Identifier
1942483433
Registry record updated Oct 30, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X
License
0791AS Issued in OH
Legal business name
PREMIER PHYSICIANS CENTERS, INC
Practice address
25200 Center Ridge Rd
Suite 3100
Westlake, OH 44145-4141
Phone
(440) 331-4559
Fax
(440) 333-2935
NPI assigned
Dec 7, 2007
Last updated
Oct 30, 2020By the provider in NPPES
Organization subpart
Yes
Parent organization
PREMIER PHYSICIANS CENTERS, INC.As reported in NPPES

NPPES NPI Registry

Updated by the provider on Oct 30, 2020

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

Authorized official

Name
Mr. Dick Fintz
Title
Interium Ceo
Phone
(440) 895-5056

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ambulatory Surgical Clinic/Center 261QA1903X 0791AS OH Primary

Addresses

Primary practice location

25200 Center Ridge Rd
Suite 3100
Westlake, OH 44145-4141

Mailing address

24500 Center Ridge Rd Ste 375
Westlake, OH 44145-5631
Phone (440) 895-5056

Other identifiers 6

IdentifierTypeStateIssuer
1942483433OtherASC NPI GROUP #
3610861OtherASC GROUP MEDICARE #
4511OtherGROUP RR MEDICARE
D368301OtherGROUP IND DIAGNOSTICS LAB
2040482MedicaidOH
490003414OtherRAILROAD MEDICARE GROUP #

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20080116000494 OH Part B Supplier - Ambulatory Surgical Center 0345153326 Practice locations: Westlake, OH

Other NPIs with the same Medicare PAC ID 5

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Care Compare: Ambulatory surgical center

Medicare Care Compare
Listed as
Premier Physicians Centers IncCCN 36C0001086
Medicare certification status
ActiveFrom the Provider of Services file

National Provider Directory

National Provider Directory
Tax ID family
Premier Physicians Centers Inc14 organizations share this tax ID, including this one
Part of
Premier Physicians Centers Inc

Other organizations with this tax ID 13

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

View all 13

Locations

25200 Center Ridge Rd
Ste 300
Westlake, OH 44145

NPI Registry JSON

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

{
    "created_epoch": "1196985600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1604016000000",
    "number": "1942483433",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "24500 CENTER RIDGE RD STE 375",
            "city": "WESTLAKE",
            "state": "OH",
            "postal_code": "441455631",
            "telephone_number": "440-895-5056",
            "fax_number": "440-333-2935"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25200 CENTER RIDGE RD",
            "address_2": "SUITE 3100",
            "city": "WESTLAKE",
            "state": "OH",
            "postal_code": "441454141",
            "telephone_number": "440-331-4559",
            "fax_number": "440-333-2935"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PREMIER PHYSICIANS CENTERS, INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "PREMIER PHYSICIANS CENTERS, INC.",
        "enumeration_date": "2007-12-07",
        "last_updated": "2020-10-30",
        "certification_date": "2020-10-30",
        "status": "A",
        "authorized_official_last_name": "FINTZ",
        "authorized_official_first_name": "DICK",
        "authorized_official_title_or_position": "INTERIUM CEO",
        "authorized_official_telephone_number": "440-895-5056",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": "OH",
            "license": "0791AS",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ASC NPI GROUP #",
            "identifier": "1942483433",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ASC GROUP MEDICARE #",
            "identifier": "3610861",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GROUP RR MEDICARE",
            "identifier": "4511",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GROUP IND DIAGNOSTICS LAB",
            "identifier": "D368301",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2040482",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE GROUP #",
            "identifier": "490003414",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Westlake, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 30, 2020; 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.