Hyde Park Surgery Center, LLC

Primary specialty

Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X

License

008677 Issued in TX

Legal business name

HYDE PARK SURGERY CENTER, LLC

Practice address

4611 Guadalupe St., Suite 100
Austin, TX 78751-2908

Phone

(512) 420-2303

Fax

(512) 420-2379

NPI assigned

Feb 28, 2008

Organization subpart

No

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

Authorized official

Name

Peter Blach

Title

Officer/Authorized Official

Phone

(713) 343-0832

Specialties & licenses 2

Addresses

Other names 1

• Hyde Park Surgery Center, LP Former legal business name

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in TX

Enrollment records 1

Listed as

Hyde Park Surgery CenterCCN 45C0001481

Medicare certification status

ActiveFrom the Provider of Services file

Member of 2

Organizations this organization is a member of, according to the National Provider Directory.

• Baylor University Medical Center

  • General Acute Care Hospital
  • Dallas, TX
  • NPI 1447250253

  Member Of

  NPD member
• VHS San Antonio Partners LLC

  • Psychiatric Hospital Unit
  • San Antonio, TX
  • NPI 1487633509

  Member Of

  NPD member

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

{
    "created_epoch": "1204156800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1728432000000",
    "number": "1962671487",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4611 GUADALUPE STREET",
            "address_2": "SUITE 100",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787512928",
            "telephone_number": "512-420-2303",
            "fax_number": "512-420-2379"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4611 GUADALUPE ST., SUITE 100",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787512908",
            "telephone_number": "512-420-2303",
            "fax_number": "512-420-2379"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HYDE PARK SURGERY CENTER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-02-28",
        "last_updated": "2024-10-09",
        "certification_date": "2024-10-09",
        "status": "A",
        "authorized_official_last_name": "BLACH",
        "authorized_official_first_name": "PETER",
        "authorized_official_title_or_position": "OFFICER/AUTHORIZED OFFICIAL",
        "authorized_official_telephone_number": "713-343-0832"
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": "TX",
            "license": "008677",
            "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": "Hyde Park Surgery Center, LP",
            "code": "4",
            "type": "Former Legal Business Name"
        },
        {
            "organization_name": "Hyde Park Surgery Center, LP",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

• Paula Jan Hyatt, LPC
• Jennifer R Hyche
• Irfan Husain Hydari, MD
• Hyde Park Counseling Center
• Hyde Park Counseling Center
• Brannon Ray Hyde, MD
• Carolyn Hyde, M.D.
• Jessica Kathryn Hyde, RN, BSN, PMHNP-BC
• Kelsey Hyde, DNP, FNP-C
• Madeline Claire Daboub Hyde, LCSW

• Ambulatory Surgical Clinic/Center in Austin, TX
• Providers in Austin, TX by specialty
• Ambulatory Surgical Clinic/Center in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 9, 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.

Verify at the official NPI Registry.