Cypress Surgery Center LLC

Primary specialty

Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X

License

S087014 Issued in KS

Legal business name

CYPRESS SURGERY CENTER LLC

Practice address

9300 E 29TH St N
Suite 100
Wichita, KS 67226-2182

Phone

(316) 634-0404

Fax

(316) 634-2995

NPI assigned

May 18, 2006

Organization subpart

No

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

Authorized official

Name

Jennifer Boyd Baldock

Title

Officer and Authorized Official

Phone

(615) 234-5954

Specialties & licenses 1

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Enrolled in KS

Enrollment records 1

Hospital certification: CCN 170206

Legal name

CYPRESS SURGERY CENTER

Certification status

Terminated Voluntary: merger or closure, Feb 1, 2022

Provider type (POS)

Hospital – Short-term

Participating since

Feb 1, 2021

Last certification

Feb 1, 2021

Beds

1

Ownership / control type

Private (for profit)

Facility address

9300 29TH Street North Suite 100
Wichita, KS 67226

Listed as

Cypress Surgery CenterCCN 17C0001050

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

Member organizations 1

Organizations listed as members of this organization in the National Provider Directory.

• Ridgewood Surgery and Endoscopy Center LLC

  • Ambulatory Surgical Clinic/Center
  • Wichita, KS
  • NPI 1356488837

  Member Of

  NPD member

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

{
    "created_epoch": "1147910400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1677628800000",
    "number": "1962455964",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 26168",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731260168",
            "telephone_number": "316-634-0404",
            "fax_number": "316-634-2995"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9300 E 29TH ST N",
            "address_2": "SUITE 100",
            "city": "WICHITA",
            "state": "KS",
            "postal_code": "672262182",
            "telephone_number": "316-634-0404",
            "fax_number": "316-634-2995"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CYPRESS SURGERY CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-18",
        "last_updated": "2023-03-01",
        "certification_date": "2023-03-01",
        "status": "A",
        "authorized_official_last_name": "BALDOCK",
        "authorized_official_first_name": "JENNIFER",
        "authorized_official_middle_name": "BOYD",
        "authorized_official_title_or_position": "OFFICER AND AUTHORIZED OFFICIAL",
        "authorized_official_telephone_number": "615-234-5954"
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": "KS",
            "license": "S087014",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "490004999",
            "state": "KS"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FEDERAL BLUE CROSS",
            "identifier": "1512",
            "state": "KS"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100387620A",
            "state": "KS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Aimee Daccache, MD

• Ambulatory Surgical Clinic/Center in Wichita, KS
• Providers in Wichita, KS by specialty
• Ambulatory Surgical Clinic/Center in Kansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 1, 2023; 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.