Village Surgicenter, Limited Partnership

Primary specialty

Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X

License

11001500 Issued in PA

Legal business name

VILLAGE SURGICENTER, LIMITED PARTNERSHIP

Practice address

5473 Village Common Dr
Ste 100
Erie, PA 16506-4961

Phone

(814) 836-0770

Fax

(814) 836-0771

NPI assigned

Jun 15, 2005

Organization subpart

No

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

Authorized official

Name

Jennifer B. Baldock

Title

Officer and Authorized Official

Phone

(615) 234-5954

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Village SurgiCenter of Erie Doing business as

Medicare fee-for-service enrollment

Enrolled in PA

Enrollment records 1

Listed as

Village Surgicenter Limited PartnershipCCN 39C0001082

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

Locations

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

{
    "created_epoch": "1118793600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1676592000000",
    "number": "1972508174",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5473 VILLAGE COMMON DR",
            "address_2": "STE 100",
            "city": "ERIE",
            "state": "PA",
            "postal_code": "165064961",
            "telephone_number": "814-836-0770",
            "fax_number": "814-836-0771"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5473 VILLAGE COMMON DR",
            "address_2": "STE 100",
            "city": "ERIE",
            "state": "PA",
            "postal_code": "165064961",
            "telephone_number": "814-836-0770",
            "fax_number": "814-836-0771"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VILLAGE SURGICENTER, LIMITED PARTNERSHIP",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-06-15",
        "last_updated": "2023-02-17",
        "certification_date": "2023-02-17",
        "status": "A",
        "authorized_official_last_name": "BALDOCK",
        "authorized_official_first_name": "JENNIFER",
        "authorized_official_middle_name": "B.",
        "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": "PA",
            "license": "11001500",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0017687800002",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Village SurgiCenter of Erie",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Village SurgiCenter of Erie",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Lisa Marie Vidakovic, P.T.
• Christopher Quiambao Vidal, P.T.
• Isabelle Marie Vieira, MAT, LAT, ATC
• Salem Vilayet, M.D.
• Ana Villace Benson, PT, DPT
• Maria Villaman, IMH-C
• Sara Villani, RRT
• Marissa Lauren Villano, PA-C
• Douglas J Villella, OD
• George J Vilushis, DO

• Ambulatory Surgical Clinic/Center in Erie, PA
• Providers in Erie, PA by specialty
• Ambulatory Surgical Clinic/Center in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 17, 2023; 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.