EVANSTON SURGICAL CENTER LLC
NPI 1003081522
Surgery in Evanston, WY
NPI Status: Active since April 25, 2008
Contact Information
196 ARROWHEAD DR
SUITE 8
EVANSTON, WY
ZIP 82930
Phone: (307) 789-1390
Fax: (307) 789-1391
- Organization
- Surgery
- CLIA Number: 53D1019796
- CLIA Cert. Type: End Stage Renal Disease Dialysis Facility
- CLIA Exp. Date: 11-30-2027
About EVANSTON SURGICAL CENTER LLC
This page provides the complete NPI Profile along with additional information for Evanston Surgical Center Llc, a provider established in Evanston, Wyoming operating as a Surgery. The healthcare provider is registered in the NPI registry with number 1003081522 assigned on April 2008. The practitioner's primary taxonomy code is 208600000X with license number 5079A (WY). The provider is registered as an organization and their NPI record was last updated 18 years ago. The organization operates as a Single Specialty Group with one or more individual practitioners, all of who practice with the same area of specialization. The authorized official of this NPI record is Dr. Michael J O'connor (Owner/md)
- NPI
- 1003081522
- Provider Name
- EVANSTON SURGICAL CENTER LLC
- Entity Type
- Organization
- Location Address
- 196 ARROWHEAD DR SUITE 8 EVANSTON, WY 82930
- Location Phone
- (307) 789-1390
- Location Fax
- (307) 789-1391
- Mailing Address
- 196 ARROWHEAD DR SUITE 8 EVANSTON, WY 82930
- Mailing Phone
- (435) 613-9500
- Mailing Fax
- (307) 789-1391
- Is Sole Proprietor?
- No
- Is Organization Subpart?
- No
- Enumeration Date
- 04-25-2008
- Last Update Date
- 10-20-2008
- Code Navigator
A surgeon like Evanston Surgical Center Llc treats injuries, diseases, and deformities through surgical operations. A surgeon could correct physical deformities, repair bone and tissue, or perform preventive or elective surgeries. Surgeons also examine patients, perform and interpret diagnostic tests, and provide counsel on preventive healthcare.
Location Map
Specialty - Primary Taxonomy
The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
- Classification
Surgery
- Taxonomy Code
- 208600000X
- Type
- Allopathic & Osteopathic Physicians
- License No.
- 5079A
- License State
- WY
- Taxonomy Description
- A general surgeon has expertise related to the diagnosis - preoperative, operative and postoperative management - and management of complications of surgical conditions in the following areas: alimentary tract; abdomen; breast, skin and soft tissue; endocrine system; head and neck surgery; pediatric surgery; surgical critical care; surgical oncology; trauma and burns; and vascular surgery. General surgeons increasingly provide care through the use of minimally invasive and endoscopic techniques. Many general surgeons also possess expertise in transplantation surgery, plastic surgery and cardiothoracic surgery.
Group Taxonomy 193400000X SINGLE SPECIALTY GROUP
This provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.
Insurance Plans Accepted
According to publicly available information the provider might be accepting the following health plans from these health insurance companies:
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
*Please verify directly with this provider to make sure your insurance plan is currently accepted.
Additional Identifiers
The NPI Enumerator encourages providers to submit additional identifiers with their NPI application although the submission of this information is optional. The additional identifier(s) section includes other numbers or codes currently or formerly used as an identifier for the provider by other public healthcare entities. The identifiers may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.
| Identifier | Type / Code | Identifier State | Identifier Issuer |
|---|---|---|---|
| F33771 | MEDICARE UPIN (02) | WY | |
| 1952367450 | MEDICAID (05) | WY | |
| W21921 | MEDICARE PIN (08) | WY |
CLIA Information
The Clinical Laboratory Improvement Amendments (CLIA) of 1988 applies to facilities or sites that test human specimens for health assessment or to diagnose, prevent, or treat disease. The CLIA Program sets standards for clinical laboratory testing and issues certificates. The NPI / CLIA crosswalk information for this NPI number is:
- CLIA Number
- 53D1019796
- Facility Type
- End Stage Renal Disease Dialysis Facility
- Certificate Effective Date
- December 01, 2025
- Certificate Expiration Date
- November 30, 2027
- Laboratory Director
- KISHORE PATCHA
- Certificate Type
- Certificate of Waiver
- Certificate Type Description
- This CLIA certificate is issued to Evanston Surgical Center Llc to perform only waived tests. CLIA defines waived tests as simple tests with a low risk for an incorrect result. Waived tests include certain tests listed in CLIA regulations, tests cleared by the FDA for home use and tests approved by the FDA for waived status and that meet CLIA waiver criteria.
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NPI NPI Number Validation
How NPI Validation Works
The NPI validation process uses the ISO-standard Luhn algorithm, a mathematical "handshake", to ensure that a provider's 10-digit ID is authentic and free of common typing errors.
To verify the NPI 1003081522, we treat the final digit (2) as the Check Digit—the target answer we need to reach. The process begins by taking the first nine digits and adding a constant value of 24, which accounts for the "80840" prefix required for all U.S. health identifiers. We then double every other digit starting from the right and sum the individual digits of those results together. For this specific NPI, that total comes to 48. The final step is to find the difference between that total and the next multiple of ten (50 - 48 = 2).
Digit-by-digit view
Use the first nine digits for the calculation. Starting from the right, double every other digit. The last digit is the check digit and is not part of the calculation.
Step 1: Double every other digit from the right
Starting with the rightmost digit of the first nine digits, double every other value. If doubling creates a two-digit number, add those digits together.
Step 2: Add all digits plus the NPI constant
Add the transformed values, the unchanged digits, and the constant 24.
Step 3: Find the amount needed to reach the next multiple of 10
The next multiple of ten after 48 is 50. The difference is the calculated check digit.
Other Providers at the Same Location
The following 16 providers are registered at the same or a nearby location.
EVANSTON, WY 82930
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1003081522, enumerated as an "organization" on April 25, 2008.
The provider is located at 196 ARROWHEAD DR SUITE 8 EVANSTON, WY 82930 and the phone number is (307) 789-1390.
Surgery with taxonomy code 208600000X.
The provider might be accepting Accepts: Medicare and Medicaid. Please consult your insurance carrier or call the provider to verify.
