PREMIER SURGERY CENTER OF THE CAROLINAS, LLC
NPI 1023839438
Clinic/Center - Ambulatory Surgical in Indian Land, SC
About Premier Surgery Center Of The Carolinas, Llc NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
PREMIER SURGERY CENTER OF THE CAROLINAS, LLC (NPI 1023839438) is a healthcare organization registered as an ambulatory surgical in Indian Land, South Carolina and active in the NPI registry since October 2024. The organization holds a CLIA Waiver certificate valid through December 12, 2026 and lists Ivan Mac, Founding Member, as its authorized official.
NPPES Registry Identity
Specialties & Licenses 2
Group Practice 1
Accepted Insurance
Medicare Participation & PECOS CMS
Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Premier Surgery Center Of The Carolinas, Llc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Clinicians Billing Medicare Through This Organization
4Medicare enrollment records show 4 clinicians reassign Medicare billing to Premier Surgery Center Of The Carolinas, LLC, which bills Medicare for the services they deliver. They are listed nearest first.
Clinicians, nearest first (4)
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
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 42D2315476
Premier Surgery Center Of The Carolinas LLC · Fort Mill, SCFrequently 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 Premier Surgery Center Of The Carolinas, LLC's NPI number?
The NPI number for Premier Surgery Center Of The Carolinas, LLC is 1023839438. It was assigned to this organization in the NPPES registry on October 18, 2024.
Where is Premier Surgery Center Of The Carolinas, LLC located?
Premier Surgery Center Of The Carolinas, LLC is located at 1170 Edgewater Corporate Pkwy Ste 106, Indian Land, SC 29707. The listed phone number is (803) 239-4504.
What is Premier Surgery Center Of The Carolinas, LLC's specialty?
The primary specialty registered for this NPI is Clinic/Center, specializing in Ambulatory Surgical, with taxonomy code 261QA1903X.
Is Premier Surgery Center Of The Carolinas, LLC enrolled in Medicare?
Yes. Premier Surgery Center Of The Carolinas, LLC is registered in the Medicare PECOS enrollment system.
How many clinicians bill Medicare through Premier Surgery Center Of The Carolinas, LLC?
According to the CMS Revalidation Reassignment List (October 2026 release), 4 clinicians, all in Ophthalmology, reassign their Medicare billing to Premier Surgery Center Of The Carolinas, LLC. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Does Premier Surgery Center Of The Carolinas, LLC hold a CLIA laboratory certificate?
Yes. A Certificate of Waiver (number 42D2315476) is associated with this NPI, valid through December 12, 2026. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.
What insurance does Premier Surgery Center Of The Carolinas, LLC accept?
Health plans from BlueCross BlueShield of South Carolina list Premier Surgery Center Of The Carolinas, LLC 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 Premier Surgery Center Of The Carolinas, LLC was last updated on June 30, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 16 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.
# Premier Surgery Center Of The Carolinas, Llc · NPI 1023839438
Ambulatory Surgical organization in Indian Land, South Carolina. Organization record, active in the CMS NPPES registry since October 18, 2024.
## Identity
- **NPI:** 1023839438 (Entity type: Organization)
- **Enumerated:** October 18, 2024
- **Primary specialty:** Clinic/Center - Ambulatory Surgical · taxonomy 261QA1903X
- **Organization subpart:** No
- **Authorized official:** Ivan Mac, FOUNDING MEMBER
## Practice location
- **Address:** 1170 EDGEWATER CORPORATE PKWY STE 106, Indian Land, SC 29707-4607
- **Phone:** (803) 239-4504
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Clinicians billing through this organization:** 4 clinicians (Ophthalmology) reassign Medicare billing to this organization (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** June 30, 2025
- **CLIA laboratory certificates:** 1 on file
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Source: [NPI Profile](https://npiprofile.com/npi/1023839438) · Data from the CMS NPPES public registry.