Active NPI
West Palm Beach Children's Surgery Center, LLC
- Ambulatory Surgical Clinic/Center
- Palm Springs, FL
National Provider Identifier
1952404550
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Ambulatory Surgical Clinic/Center
- Legal business name
- WEST PALM BEACH CHILDREN'S SURGERY CENTER, LLC
- Practice address
- 1620 S Congress Ave Ste 100
Palm Springs, FL 33461-2128 - Phone
- (561) 968-2007
- Fax
- (561) 968-1046
- NPI assigned
- Sep 7, 2006
- Last updated
- Feb 20, 2026
- 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
- Devin Larsen
- Title
- Ceo
- Phone
- (631) 445-0593
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Ambulatory Surgical Clinic/Center | 261QA1903X | NU | Primary |
Addresses
Primary practice location
1620 S Congress Ave Ste 100
Palm Springs, FL 33461-2128
Mailing address
9709 Lakeside Blvd Ste 350
Spring, TX 77381-1216
Phone (713) 489-2198
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 119589000 | Medicaid | FL |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in FL
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20070919000686 | FL | Part B Supplier - Ambulatory Surgical Center | 8325132566 | Practice locations: Palm Springs, FL |
Care Compare: Ambulatory surgical center
Medicare Care Compare- Listed as
- Outpatient Plastic 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 |
|---|---|---|---|
| 10D0990668 | West Palm Beach Children's Surgery Center LLC | Certificate of waiver | Aug 28, 2027 |
National Provider Directory
National Provider DirectoryPractitioners & affiliated clinicians
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.
-
- Plastic Surgery Physician
- West Palm Beach, FL
- NPI 1750366126
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1157587200000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1771545600000",
"number": "1952404550",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "9709 LAKESIDE BLVD STE 350",
"city": "SPRING",
"state": "TX",
"postal_code": "773811216",
"telephone_number": "713-489-2198",
"fax_number": "713-489-2978"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1620 S CONGRESS AVE STE 100",
"city": "PALM SPRINGS",
"state": "FL",
"postal_code": "334612128",
"telephone_number": "561-968-2007",
"fax_number": "561-968-1046"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "WEST PALM BEACH CHILDREN'S SURGERY CENTER, LLC",
"organizational_subpart": "NO",
"enumeration_date": "2006-09-07",
"last_updated": "2026-02-20",
"certification_date": "2026-02-20",
"status": "A",
"authorized_official_last_name": "LARSEN",
"authorized_official_first_name": "DEVIN",
"authorized_official_title_or_position": "CEO",
"authorized_official_telephone_number": "631-445-0593"
},
"taxonomies": [
{
"code": "261QA1903X",
"taxonomy_group": "",
"desc": "Clinic/Center, Ambulatory Surgical",
"state": "NU",
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "119589000",
"state": "FL"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Palm Springs, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 20, 2026; 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.