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SAGAMORE SURGICAL SERVICES, INC.
NPI 1003816307
Clinic/Center - Ambulatory Surgical in Lafayette, IN

Active since July 28, 2005CLIA 15D0886942 · Waiver
2320 CONCORD RD, STE B, LAFAYETTE, IN 47909(765) 474-7854 Get Directions Write a Review

NPPES record last updated: April 22, 2025. Verified against the NPPES registry weekly; last sync: October 18, 2026.

About Sagamore Surgical Services, Inc. NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

SAGAMORE SURGICAL SERVICES, INC. (NPI 1003816307) is a healthcare organization registered as an ambulatory surgical in Lafayette, Indiana and active in the NPI registry since July 2005. The organization holds a CLIA Waiver certificate valid through May 31, 2028 and lists Shelby Atkinson Brouillette, Administrator Don, as its authorized official.

NPPES Registry Identity

NPI1003816307
Entity TypeOrganization
Primary Taxonomy261QA1903X
Legal Business NameSAGAMORE SURGICAL SERVICES, INC.
Location Address2320 CONCORD RD, STE BLafayette, IN 47909-2708
Mailing AddressPo Box 112Muncie, IN 47308-0112 · (765) 284-0493 · Fax (765) 284-2434
Phone(765) 474-7854
Organization SubpartNo
Authorized OfficialShelby Atkinson BrouilletteAdministrator Don · (765) 474-7838
Enumeration DateJuly 28, 2005
Last NPPES UpdateApril 22, 2025
NPPES CertifiedApril 22, 2025
✔ NPI 1003816307 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyClinic/Center · Ambulatory SurgicalAmbulatory Health Care Facilities
Taxonomy Code261QA1903X
License✔ Licensed in IN · 05-006126-1
2320 CONCORD RD, Lafayette, IN 47909
Open in Google Maps ↗

Other Identifiers 1

Medicaid100274550AIN

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Buckeye Health Plan, Ambetter from Meridian, Ambetter Health and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment and revalidation status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Sagamore Surgical Services, Inc. is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Medicare Revalidation Due Date

Revalidation due by December 31, 2026

Medicare-enrolled providers and suppliers confirm their enrollment information with CMS on a set cycle, every 5 years for most and every 3 years for medical equipment suppliers. CMS sets the due date for each enrollment.

StateEnrollment IDDue date
StateIndianaEnrollment IDO20080529000584Non-DME Part B · Ambulatory Surgical CenterDue dateDecember 31, 2026
Source: CMS Revalidation Due Date List, October 2026 release.

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 15D0886942

Sagamore Surgical Services Inc · Lafayette, IN
Active · expires May 31, 2028
CLIA Number15D0886942
Laboratory TypeAmbulatory Surgery Center
Certificate Effective DateJune 1, 2026
Certificate Expiration DateMay 31, 2028
Laboratory DirectorPatrick R. Oneil
Laboratory Phone(765) 474-7838
Laboratory LocationSagamore Surgical Services Inc2320 Concord Road, Suite B, Lafayette, IN 47909
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Areas of Expertise CMS Part B claims 2

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Incision of eardrum with placement of eardrum tube under general anesthesia 69436
This procedure involves making a small cut in the eardrum to drain fluid and alleviate pressure. A tiny tube is then inserted to keep the hole open and prevent further fluid buildup. General anesthesia is used to ensure patient comfort.
33 services21 patients
Evaluation of sleep-disordered breathing by examination of upper airway using an endoscope 42975
This procedure examines your upper airway for sleep-related breathing issues. An endoscope, a thin tube with a light and camera, is gently inserted through your nose. This allows a detailed view of your airway to identify any abnormalities that could disrupt your sleep.
11 services11 patients

Other Providers at the Same Location NPPES 4

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

AUDIO DIAGNOSTICS II INC
Hearing Aid Equipment
2320 CONCORD RD, SUITE B
LAFAYETTE, IN 47909
Tippecanoe County (765) 477-7436
MRS. CHRISTINE A CAMPBELL MS
Audiologist
2320 CONCORD RD, C/O LAFAYETTE ENT
LAFAYETTE, IN 47909
Tippecanoe County (765) 477-7436
PATRICK R O'NEIL M.D.
Anesthesiology
2320 CONCORD RD, SUITE C
LAFAYETTE, IN 47909
Tippecanoe County (317) 567-2180
LAFAYETTE OTOLARYNGOLOGY ASSOCIATES, INC
Otolaryngology
2320 CONCORD RD
LAFAYETTE, IN 47909
Tippecanoe County (765) 477-7436

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Sagamore Surgical Services, Inc.'s NPI number?

The NPI number for Sagamore Surgical Services, Inc. is 1003816307. It was assigned to this organization in the NPPES registry on July 28, 2005.

Where is Sagamore Surgical Services, Inc. located?

Sagamore Surgical Services, Inc. is located at 2320 Concord Rd Ste B, Lafayette, IN 47909. The listed phone number is (765) 474-7854.

What is Sagamore Surgical Services, Inc.'s specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Ambulatory Surgical, with taxonomy code 261QA1903X.

Is Sagamore Surgical Services, Inc. enrolled in Medicare?

Yes. Sagamore Surgical Services, Inc. is registered in the Medicare PECOS enrollment system.

When is Sagamore Surgical Services, Inc.'s Medicare revalidation due?

According to the CMS Revalidation Due Date List (October 2026 release), the Medicare Non-DME Part B enrollment for this organization (Indiana, Ambulatory Surgical Center) is due for revalidation by December 31, 2026. Medicare providers and suppliers revalidate their enrollment every 5 years, and medical equipment suppliers every 3 years. Confirm current requirements with your Medicare Administrative Contractor.

Does Sagamore Surgical Services, Inc. hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 15D0886942) is associated with this NPI, valid through May 31, 2028. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

What insurance does Sagamore Surgical Services, Inc. accept?

Health plans from Ambetter Health, Ambetter from Buckeye Health Plan, Ambetter from Meridian and Anthem Blue Cross and Blue Shield list Sagamore Surgical Services, Inc. as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Sagamore Surgical Services, Inc. was last updated on April 22, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 18 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.