NEWCO AMBULATORY SURGERY CENTER, LLP (NPI# 1629079611) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1629079611 |
| Entity Type | Organization |
| Organization Name | NEWCO AMBULATORY SURGERY CENTER, LLP |
| Other Organization Name | LAKESHORE SURGERY CENTER, LLP |
| Practice Address |
4190 24th Ave Fort Gratiot MI 48059-3882 |
| Practice Telephone | 8109897649 |
| Practice Fax Number | 8109897652 |
| Mailing Fax Number | 8109897652 |
| Enumeration Date | 2005-08-02 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | MR. TIMOTHY P CONNELL (ADMINISTRATOR) |
| Authorized Official Telephone | 8109897751 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QA1903X |
Clinic/Center Specialization: Ambulatory Surgical |
746818 | MI | Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| FIRST HEALTH | 30036708 | 01 | |
| BLUE CARE NETWORK | 40221 | 01 | |
| PREFERRED CHOICES | 139016 | 01 | |
| CARE CHOICES | 139016 | 01 | |
| HEALTH PLAN OF MICHIGAN | 32463 | 01 | |
| MI | BLUE CROSS BLUE SHIELD | 40221 | 01 |
| MI | GREAT LAKES HEALTH PLAN | 143728 | 01 |
| CIGNA | 4563971 | 01 |
| Other Name | Type Code |
|---|---|
| LAKESHORE SURGERY CENTER, LLP | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1811944192 | Newco Ambulatory Surgery Center, LLP | Nurse Anesthetist, Certified Registered | 4190 24th Ave, Fort Gratiot, MI 48059-3882 | 2006-05-30 |
| Street Address |
4190 24TH AVE |
| City | FORT GRATIOT |
| State | MI |
| Zip Code | 48059-3882 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518513027 | Aiso Pllc | Clinic/Center | 4190 24th Ave, Fort Gratiot, MI 48059-3882 | 2019-08-12 |
| 1588109177 | Heather Kakos | Nurse Anesthetist, Certified Registered | 4190 24th Ave, Fort Gratiot, MI 48059-3882 | 2017-01-05 |
| 1891246021 | Lake Huron Urgent Care Center, LLC | Internal Medicine | 4190 24th Ave, Fort Gratiot, MI 48059-3882 | 2016-10-24 |
| 1134586852 | Prime Healthcare Services-port Huron, LLC | Clinic/Center | 4190 24th Ave, Fort Gratiot, MI 48059-3882 | 2016-01-26 |
| 1598141640 | Port Huron Physicians Medical Group PC | Internal Medicine | 4190 24th Ave, Suite 206, Fort Gratiot, MI 48059-3882 | 2015-07-30 |
| 1902281736 | Port Huron Physicians Medical Group PC | Internal Medicine | 4190 24th Ave, Ste 206, Fort Gratiot, MI 48059-3882 | 2015-07-22 |
| 1033505110 | Prime Garden City Medical Group | Internal Medicine | 4190 24th Ave, Suite 206, Fort Gratiot, MI 48059-3882 | 2015-04-15 |
| 1003204660 | Beverlie Houser | Nurse Practitioner | 4190 24th Ave, Fort Gratiot, MI 48059-3882 | 2015-01-06 |
| 1942615414 | Mercy Surgery Care Network | Internal Medicine | 4190 24th Ave, Suite 206, Fort Gratiot, MI 48059-3882 | 2014-06-24 |
| 1740424001 | Rashim K Gupta | Internal Medicine | 4190 24th Ave, Suite 206, Fort Gratiot, MI 48059-3882 | 2009-04-29 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1679096374 | Rebecca Campau | Registered Nurse | 4985 Lakeshore Rd, Fort Gratiot, MI 48059 | 2017-07-25 |
| 1598175481 | David Kelley Sr. | Pharmacist | 4475 24th Ave., Fort Gratiot, MI 48059 | 2014-05-01 |
| 1316110968 | Apheresis and Transfusion Medicine of Port Huron Pllc | Pathology | 4970 Lakeshore Road, Fort Gratiot, MI 48059 | 2008-04-03 |
| 1275754152 | Jennifer Ann Peyerk | Physical Therapist | 3902 Arlington Ave., Fort Gratiot, MI 48059 | 2007-05-01 |
| 1013097278 | Randy John Plonka | Internal Medicine | 5979 Lakeshore, Ft Gratiot, MI 48059 | 2006-10-16 |
| 1881708428 | John Nathan Seppo | Social Worker | 3847 Pine Grove Avenue, Fort Gratiot, MI 48059 | 2006-08-19 |
| 1396756615 | Blue Water Family Dentistry PC | Dentist | 4044 24th Ave, Fort Gratiot, MI 48059 | 2006-08-11 |
| 1720018823 | Minden City Community Healthcare Outreach | Clinic/Center | 28 Deer Creek Drive, Fort Gratiot, MI 48059 | 2006-07-04 |
| 1982103966 | Luke Michael Privette | Physical Therapist | 4351 24th Ave Ste 1, Fort Gratiot, MI 48059 | 2018-02-06 |
| 1194115352 | Rachel Brooks | Chiropractor | 2844 Krafft Rd, Fort Gratiot, MI 48059 | 2015-01-27 |
| Find all providers in zip 48059 | ||||
| Taxonomy Code | 261QA1903X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Ambulatory Surgical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134586852 | Prime Healthcare Services-port Huron, LLC | Clinic/Center | 4190 24th Ave, Fort Gratiot, MI 48059-3882 | 2016-01-26 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891306114 | Spine and Joint Surgical Institute of Michigan, LLC | Clinic/Center | 5140 Coolidge Hwy, Ste 200, Royal Oak, MI 48073 | 2020-08-11 |
| 1588285050 | Hall Road Asc LLC | Clinic/Center | 11051 Hall Rd Ste 100, Utica, MI 48317-5737 | 2020-05-06 |
| 1235750431 | Precision Surgery Center LLC | Clinic/Center | 22701 Hall Road, Macomb, MI 48042 | 2020-04-29 |
| 1790306991 | Grass Lake Surgery Center LLC | Clinic/Center | 3800 Centennial Blvd, Grass Lake, MI 49240 | 2020-04-29 |
| 1992339147 | Movi Asc Management LLC | Clinic/Center | 5250 Auto Club Drive, Suite 170, Dearborn, MI 48126-2619 | 2020-02-26 |
| 1609409929 | Firestone Procedure Center LLC | Clinic/Center | 4520 Firestone St Ste C, Dearborn, MI 48126-4602 | 2020-02-14 |
| 1255972113 | Center Health Surgery Center LLC | Clinic/Center | 30671 Stephenson Hwy Ste F, Madison Heights, MI 48071-1635 | 2019-10-02 |
| 1942851639 | Northern Michigan Surgical Suites, LLC | Clinic/Center | 825 Moll Dr, Boyne City, MI 49712-9182 | 2019-09-24 |
| 1699328146 | Alliance Surgery Center, LLC | Clinic/Center | 3663 North Country Drive, Traverse City, MI 49684-4587 | 2019-07-23 |
| 1407313802 | Spectrum Health Hospitals | Clinic/Center | 4069 Lake Dr Se Ste 210, Grand Rapids, MI 49546-8816 | 2019-02-22 |
| Find all providers with the same taxonomy | ||||
| City | FORT GRATIOT |
| Zip Code | 48059 |
Please comment or provide details below to improve the information on NEWCO AMBULATORY SURGERY CENTER, LLP.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.