Active NPI
Safety Harbor ASC Company LLC
Doing business as Safety Harbor Surgery Center
- Ambulatory Surgical Clinic/Center
- Clearwater, FL
National Provider Identifier
1942715826
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Ambulatory Surgical Clinic/Center
- Legal business name
- SAFETY HARBOR ASC COMPANY LLC
- Doing business as
- Safety Harbor Surgery Center
- Practice address
- 3280 N McMullen Booth Rd Ste 110
Clearwater, FL 33761-2046 - Phone
- (727) 787-3000
- Fax
- (727) 787-3008
- NPI assigned
- Dec 13, 2017
- Last updated
- Oct 11, 2024
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Collin Lemaistre
- Title
- Officer/Authorized Official
- Phone
- (214) 213-0732
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Ambulatory Surgical Clinic/Center | 261QA1903X | NU | Primary |
Addresses
Primary practice location
3280 N McMullen Booth Rd Ste 110
Clearwater, FL 33761-2046
Mailing address
3280 N McMullen Booth Rd Ste 110
Clearwater, FL 33761-2046
Phone (727) 787-3000
Other names 1
- SAFETY HARBOR SURGERY CENTER
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| CONNECT URL | https://esmd.abilitynetwork.com:8291/gateway/documentsubmission/2_0/NhinService/XDRRequest_Service | Other | Ability Network |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in FL
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20180428000048 | FL | Part B Supplier - Ambulatory Surgical Center | 8729342761 | Practice locations: Clearwater, FL |
Care Compare: Ambulatory surgical center
Medicare Care Compare- Listed as
- Safety Harbor ASC Company LLC Dba Safety Harbor Surgery Center
- Medicare certification status
- Active
Laboratory certificates & supplier records
Derived by NPIMapThese CMS records do not include an NPI. They are shown because their name and street address match this provider’s.
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 10D2018949 | Safety Harbor ASC Center LLC | Certificate of waiver | Jan 18, 2027 |
National Provider Directory
National Provider DirectoryMember of 2
Organizations this organization is a member of, according to the National Provider Directory.
-
- Durable Medical Equipment & Medical Supplies
- Dallas, TX
- NPI 1518967231
Member Of
-
dba Baptist Health System
- Psychiatric Hospital Unit
- San Antonio, TX
- NPI 1487633509
Member Of
Networks
- Freedom Health HMO Network
- Optimum HealthCare HMO Network
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1513123200000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1728604800000",
"number": "1942715826",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3280 N MCMULLEN BOOTH RD STE 110",
"city": "CLEARWATER",
"state": "FL",
"postal_code": "337612046",
"telephone_number": "727-787-3000",
"fax_number": "727-787-3008"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3280 N MCMULLEN BOOTH RD STE 110",
"city": "CLEARWATER",
"state": "FL",
"postal_code": "337612046",
"telephone_number": "727-787-3000",
"fax_number": "727-787-3008"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "SAFETY HARBOR ASC COMPANY LLC",
"organizational_subpart": "NO",
"enumeration_date": "2017-12-13",
"last_updated": "2024-10-11",
"certification_date": "2024-10-11",
"status": "A",
"authorized_official_last_name": "LEMAISTRE",
"authorized_official_first_name": "COLLIN",
"authorized_official_title_or_position": "OFFICER/AUTHORIZED OFFICIAL",
"authorized_official_telephone_number": "214-213-0732"
},
"taxonomies": [
{
"code": "261QA1903X",
"taxonomy_group": "",
"desc": "Clinic/Center, Ambulatory Surgical",
"state": "NU",
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "CONNECT",
"endpointTypeDescription": "CONNECT URL",
"endpoint": "https://esmd.abilitynetwork.com:8291/gateway/documentsubmission/2_0/NhinService/XDRRequest_Service",
"affiliation": "Y",
"endpointDescription": "2.16.840.1.113883.3.667.2",
"affiliationName": "Ability Network",
"use": "OTHER",
"useDescription": "Other",
"useOtherDescription": "CMS esMD eMDR",
"address_1": "100 N 6th St Ste 900A",
"city": "Minneapolis",
"state": "MN",
"country_code": "US",
"postal_code": "554031516",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": [
{
"organization_name": "SAFETY HARBOR SURGERY CENTER",
"code": "3",
"type": "Doing Business As"
}
]
}
Other providers in Clearwater, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 11, 2024; 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.