Modern Ambulatory Surgery Center, PC

Primary specialty

Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X

Legal business name

MODERN AMBULATORY SURGERY CENTER, PC

Practice address

4860 E Baseline Road
Suite 101
Mesa, AZ 85206-4670

Phone

(602) 265-8800

Fax

(602) 265-8151

NPI assigned

Oct 7, 2013

Organization subpart

No

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

Authorized official

Name

Leslie Daugherty

Title

Administrator

Phone

(602) 265-8800

Specialties & licenses 1

Addresses

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

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

{
    "created_epoch": "1381104000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1381104000000",
    "number": "1982031936",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1301 E MCDOWELL RD",
            "address_2": "SUITE 100",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850062621",
            "telephone_number": "602-265-8800",
            "fax_number": "602-265-8151"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4860 E BASELINE ROAD",
            "address_2": "SUITE 101",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852064670",
            "telephone_number": "602-265-8800",
            "fax_number": "602-265-8151"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MODERN AMBULATORY SURGERY CENTER, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-10-07",
        "last_updated": "2013-10-07",
        "status": "A",
        "authorized_official_last_name": "DAUGHERTY",
        "authorized_official_first_name": "LESLIE",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "602-265-8800"
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Ambulatory Surgical Clinic/Center in Mesa, AZ
• Providers in Mesa, AZ by specialty
• Ambulatory Surgical Clinic/Center in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 7, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• 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.