BURNSIDE SURGERY CENTER LLC
NPI 1013417351
Clinic/Center - Ambulatory Surgical in Gresham, OR

NPI Status: Active since February 13, 2018

Contact Information

689 NW BURNSIDE RD FL 1
GRESHAM, OR
ZIP 97030
Phone: (503) 382-8140

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  • Organization
  • Clinic/Center
  • Ambulatory Surgical
  • Accepts Insurance
  • CLIA Number: 38D2150925
  • CLIA Cert. Type: Ambulatory Surgery Center
  • CLIA Exp. Date: 07-05-2026

About BURNSIDE SURGERY CENTER LLC

This page provides the complete NPI Profile along with additional information for Burnside Surgery Center Llc, a provider established in Gresham, Oregon operating as a Clinic/center, focusing in ambulatory surgical . The healthcare provider is registered in the NPI registry with number 1013417351 assigned on February 2018. The practitioner's primary taxonomy code is 261QA1903X with license number 07-1645 (OR). The provider is registered as an organization and their NPI record was last updated 5 years ago. Burnside Surgery Center Llc operates as a Multi-Specialty Group with one or more individual practitioners, who practice different areas of specialization. The authorized official of this NPI record is Dr. Oleg Maksimov (Director)

NPI
1013417351
Provider Name
BURNSIDE SURGERY CENTER LLC
Entity Type
Organization
Location Address
689 NW BURNSIDE RD FL 1 GRESHAM, OR 97030
Location Phone
(503) 382-8140
Mailing Address
689 NW BURNSIDE RD FL 1 GRESHAM, OR 97030
Is Sole Proprietor?
No
Is Organization Subpart?
No
Enumeration Date
02-13-2018
Last Update Date
05-23-2021
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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

Clinic/Center Ambulatory Surgical

Taxonomy Code
261QA1903X
Type
Ambulatory Health Care Facilities
License No.
07-1645
License State
OR

Secondary Taxonomies

The provider has reported to the NPI enumerator additional taxonomy codes. Multiple taxonomy codes may represent subspecialties or other areas of specialization the provider maybe licensed to practice.

No. Taxonomy Code Type Classification /
Specialization
License No. (State)
12081P2900XAllopathic & Osteopathic Physicians

Physical Medicine & Rehabilitation
Pain Medicine

MD28526 (OR)

Group Taxonomy 193200000X MULTI-SPECIALTY GROUP

This provider is a business group of one or more individual practitioners, who practice with different areas of specialization.

Insurance Plans Accepted

According to publicly available information the provider might be accepting the following health plans from these health insurance companies:

  • BridgeSpan Standard Bronze Plan - EPO
  • BridgeSpan Standard Gold Plan - EPO
  • BridgeSpan Standard Silver Plan - EPO
  • Moda Health Affinity Bronze 8000 - EPO
  • Moda Health Affinity Bronze 9000 - EPO
  • Moda Health Affinity Bronze HDHP 7500 - EPO
  • Moda Health Affinity Gold 1000 - EPO
  • Moda Health Affinity Gold 1500 - EPO
  • Moda Health Affinity Gold 250 - EPO
  • Moda Health Affinity Silver 3000 - EPO
  • Moda Health Affinity Silver 3400 - EPO
  • Moda Health Affinity Silver 4500 - EPO
  • Moda Health Affinity Silver 6000 - EPO
  • Moda Health Oregon Standard Bronze Affinity - EPO
  • Moda Health Oregon Standard Gold Affinity - EPO
  • Moda Health Oregon Standard Silver Affinity - EPO
  • HSA Qualified 7500 Bronze - Choice Network - EPO
  • HSA-E Qualified 7500 Bronze - Signature Network - EPO
  • Providence Oregon Standard Bronze Plan - Choice Network - EPO
  • Providence Oregon Standard Bronze Plan - Signature Network - EPO
  • Providence Oregon Standard Gold Plan - Choice Network - EPO
  • Providence Oregon Standard Gold Plan - Signature Network - EPO
  • Providence Oregon Standard Silver Plan - Choice Network - EPO
  • Providence Oregon Standard Silver Plan - Signature Network - EPO
  • Bronze 8000 Individual Connect - EPO
  • Bronze Essential 9000 With 4 Copay No Deductible Office Visits Individual Connect - EPO
  • Bronze HSA 7000 Individual Connect - EPO
  • Gold 2300 Individual Connect - EPO
  • Regence Standard Bronze Plan Individual Connect - EPO
  • Regence Standard Gold Plan Individual Connect - EPO
  • Regence Standard Silver Plan Individual Connect - EPO
  • Silver 6500 Individual Connect - EPO

*Please verify directly with this provider to make sure your insurance plan is currently accepted.

Authorized Official

The authorized official is the designated individual with the legal authority to make changes to the provider’s official NPI record. For organizations, the authorized official must be a general partner, chairman of the board, CEO, CFO or a direct owner holding at least a 5 percent stake in the medical organization.

Authorized Official Name

DR. OLEG MAKSIMOV

Authorized Official Title
DIRECTOR
Authorized Official Phone
(503) 915-9217

Areas of Expertise

The following services and procedures, recently provided to Medicare patients, illustrate the range of care this provider offers. This list reflects the variety of services available to all patients visiting the practice and is based on 2022 Medicare dataset. In general, the more frequently a provider treats specific conditions or performs particular procedures, the more experienced they become in addressing similar patient needs. The provider has delivered many of the services listed below to Medicare patients. Please note that this list does not include services provided to patients who are not covered by Medicare.

Aspiration and/or injection of fluid from large joint

This procedure involves using a needle to remove (aspiration) or introduce (injection) fluid into a large joint like the knee or hip. It can help diagnose conditions, relieve discomfort, or deliver medication directly to the joint.

This service was performed 54 times for 31 patients

Aspiration and/or injection of fluid large joint using ultrasound guidance

This procedure involves using ultrasound technology to accurately locate a large joint, usually the knee or shoulder. A needle is then inserted to either extract fluid (aspiration) or inject medication. The ultrasound helps ensure precision and safety.

This service was performed 17 times for 13 patients

Destruction of lower or sacral spinal facet joint nerves using imaging guidance, single facet joint

This procedure involves using imaging guidance to accurately target and destroy nerves in the lower or sacral spinal facet joint. It's done to relieve chronic back pain. The process is safe and usually effective.

This service was performed 110 times for 54 patients

Destruction of upper or middle spinal facet joint nerves using imaging guidance, single facet joint

This procedure involves the use of imaging technology to guide a needle to the nerves of a single facet joint in the upper or middle spine. The nerves are then treated to alleviate pain and improve mobility.

This service was performed 21 times for 11 patients

Injection of anesthetic and/or steroid drug into sacral spine nerve root using imaging guidance, single level

This procedure involves injecting a mix of numbing and anti-inflammatory medication into a specific nerve root in the lower back. It helps manage pain and reduce inflammation. The process is guided by imaging technology for precision.

This service was performed 155 times for 77 patients

Injection of anesthetic and/or steroid drug into upper or middle spine nerve root using imaging guidance, single level

This procedure involves injecting anesthetic or steroid medication into a specific nerve root in the upper or middle spine. It's performed using imaging technology for precise placement. The aim is to reduce inflammation and alleviate pain.

This service was performed 18 times for 11 patients

Injection of lower or sacral spine facet joint using imaging guidance, single level

This procedure involves injecting medication into the facet joint in your lower back or sacral spine. It's done under imaging guidance to ensure accuracy. The aim is to alleviate pain and inflammation. It's a safe, often effective method for managing spinal discomfort.

This service was performed 112 times for 39 patients

Injection procedure for sacroiliac joint; provision of anesthetic, steroid and/or other therapeutic agent, with or without arthrography

This procedure involves injecting medicine into the sacroiliac joint, located in the lower back. The aim is to reduce inflammation and pain. Anesthetic is used for immediate pain relief, while a steroid helps decrease inflammation over time. Arthrography, a type of imaging, may be used for precision.

This service was performed 34 times for 17 patients

Insertion of spinal neurostimulator electrode array through skin

This procedure involves placing a small device, called a neurostimulator electrode array, under your skin near your spine. It delivers mild electrical signals to your spinal cord, helping to manage chronic pain.

This service was performed 50 times for 17 patients

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
38D2150925
Facility Type
Ambulatory Surgery Center
Certificate Effective Date
July 06, 2024
Certificate Expiration Date
July 05, 2026
Laboratory Director
OLEG I. MAKSIMOV MD
Certificate Type
Certificate of Waiver
Certificate Type Description
This CLIA certificate is issued to Burnside Surgery 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 1013417351, we treat the final digit (1) 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 49. The final step is to find the difference between that total and the next multiple of ten (50 - 49 = 1).

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.

Pos 1
1
Doubled → 2
Pos 2
0
Unchanged
Pos 3
1
Doubled → 2
Pos 4
3
Unchanged
Pos 5
4
Doubled → 8
Pos 6
1
Unchanged
Pos 7
7
Doubled → 14 → 1 + 4
Pos 8
3
Unchanged
Pos 9
5
Doubled → 10 → 1 + 0
Check
1
Target digit
Regular digit Doubled digit Check digit

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.

1 → 2 1 → 2 4 → 8 7 → 14 → 5 5 → 10 → 1

Step 2: Add all digits plus the NPI constant

Add the transformed values, the unchanged digits, and the constant 24.

2 + 0 + 2 + 3 + 8 + 1 + 1 + 4 + 3 + 1 + 0 + 24 = 49

Step 3: Find the amount needed to reach the next multiple of 10

The next multiple of ten after 49 is 50. The difference is the calculated check digit.

50 - 49 = 1
This NPI is valid
The calculated check digit is 1, which matches the last digit of 1013417351.

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1013417351, enumerated as an "organization" on February 13, 2018.

The provider is located at 689 NW BURNSIDE RD FL 1 GRESHAM, OR 97030 and the phone number is (503) 382-8140.

Clinic/Center with taxonomy code 261QA1903X and a focus in Ambulatory Surgical.

The provider might be accepting Accepts: BridgeSpan Health Company, Moda Health Plan, Inc.,. Please consult your insurance carrier or call the provider to verify.