SURGERY CENTER OF ST. JOSEPH, LLC
NPI 1104857523
Clinic/Center - Ambulatory Surgical in Saint Joseph, MO
NPI Status: Active since July 05, 2006
Contact Information
3201 ASHLAND AVE
SAINT JOSEPH, MO
ZIP 64506
Phone: (816) 279-0079
Fax: (816) 364-1100
- Organization
- Clinic/Center
- Ambulatory Surgical
- Accepts Insurance
- CLIA Number: 26D0707725
- CLIA Cert. Type: Ambulatory Surgery Center
- CLIA Exp. Date: 08-31-2026
About SURGERY CENTER OF ST. JOSEPH, LLC
This page provides the complete NPI Profile along with additional information for Surgery Center Of St. Joseph, Llc, a provider established in Saint Joseph, Missouri operating as a Clinic/center, focusing in ambulatory surgical . The healthcare provider is registered in the NPI registry with number 1104857523 assigned on July 2006. The practitioner's primary taxonomy code is 261QA1903X with license number 119-3 (MO). The provider is registered as an organization and their NPI record was last updated 14 years ago. The authorized official of this NPI record is Angela J Fry (Clinic Director)
- NPI
- 1104857523
- Provider Name
- SURGERY CENTER OF ST. JOSEPH, LLC
- Entity Type
- Organization
- Location Address
- 3201 ASHLAND AVE SAINT JOSEPH, MO 64506
- Location Phone
- (816) 279-0079
- Location Fax
- (816) 364-1100
- Mailing Address
- 3201 ASHLAND AVE SAINT JOSEPH, MO 64506
- Mailing Phone
- (816) 279-0079
- Mailing Fax
- (816) 364-1100
- Is Sole Proprietor?
- No
- Is Organization Subpart?
- No
- Enumeration Date
- 07-05-2006
- Last Update Date
- 04-05-2012
- Code Navigator
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
Clinic/Center Ambulatory Surgical
- Taxonomy Code
- 261QA1903X
- Type
- Ambulatory Health Care Facilities
- License No.
- 119-3
- License State
- MO
Insurance Plans Accepted
According to publicly available information the provider might be accepting the following health plans from these health insurance companies:
- Anthem Bronze Pathway 10150 ($0 Virtual PCP + $0 Select Drugs + Incentives) - EPO
- Anthem Bronze Pathway 6900 ($0 Virtual PCP + $0 Select Drugs + Incentives) - EPO
- Anthem Bronze Pathway 7500 Standard ($0 Virtual PCP + $0 Select Drugs + Incentives) - EPO
- Anthem Catastrophic Pathway (+ Incentives) - EPO
- Anthem Gold Pathway 2000 Standard ($0 Virtual PCP + $0 Select Drugs + Incentives) - EPO
- Anthem Heart Healthy Bronze Pathway 4900 ($0 Virtual PCP + $0 Select Drugs + Incentives) - EPO
- Anthem Heart Healthy Silver Pathway 3100 ($0 Virtual PCP + $0 Select Drugs + Incentives) - EPO
- Anthem Silver Pathway 5350 ($0 Virtual PCP + $0 Select Drugs + Incentives) - EPO
- Anthem Silver Pathway 6000 Standard ($0 Virtual PCP + $0 Select Drugs + Incentives) - EPO
- Anthem Silver Pathway 7200 ($0 Virtual PCP + $0 Select Drugs + Incentives) - EPO
- Bronze Classic 4700 - EPO
- Bronze Classic Standard - EPO
- Bronze Elite + PCP Saver - EPO
- Bronze Elite + PCP Saver Plus - EPO
- Bronze Simple Diabetes - EPO
- Gold Classic Standard - EPO
- Gold Simple - EPO
- Silver Classic Standard - EPO
- Silver Elite Saver Plus - EPO
- Silver Simple Diabetes - EPO
- Silver Simple PCP Saver - EPO
- Silver Simple Women's Health with Menopause Benefits - EPO
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 |
|---|---|---|---|
| 9004187 | MEDICARE ID-TYPE UNSPECIFIED (04) | MO | |
| 26C0001012 | OTHER (01) | MO | MEDICARE SUPPLIER |
| 502343502 | MEDICAID (05) | MO |
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.
Complex removal of cataract with insertion of prosthetic lens
Extracapsular removal of cataract with insertion of artificial lens and insertion of drainage device in front chamber of eye
Injection of medication into eye
Injection, bimatoprost, intracameral implant, 1 microgram
Laser repair to improve eye fluid flow
Removal of cataract with insertion of prosthetic lens
Removal of excessive skin and fat of upper eyelid
Removal of recurring cataract in lens capsule using a laser
This procedure involves removing a cloudy lens (cataract) from your eye and replacing it with a clear, artificial lens. It helps restore vision that has been affected by the cataract. The operation is usually done under local anesthesia.
This service was performed 22 times for 14 patientsThis is a two-part eye procedure. First, a cloudy lens (cataract) is removed from its outer layer and replaced with an artificial lens to improve vision. Second, a drainage device is inserted into the front part of the eye to manage fluid levels, preventing pressure build-up.
This service was performed 30 times for 17 patientsThis procedure involves administering medication directly into your eye. A tiny needle is used to deliver the drug into the vitreous, a jelly-like substance in the eye. It helps treat conditions like macular degeneration or diabetic retinopathy. It's generally safe and effective.
This service was performed 39 times for 27 patientsThis procedure involves placing a tiny implant inside the eye, which releases a drug called bimatoprost. This drug helps to lower high pressure in the eye, typically seen in conditions like glaucoma. It's a safe and effective treatment.
This service was performed 390 times for 27 patientsLaser repair to improve eye fluid flow is a procedure aimed at treating glaucoma. A laser is used to create a small hole in the eye's drainage system, allowing fluid to flow out more easily. This helps to lower the pressure inside the eye, reducing the risk of vision loss.
This service was performed 28 times for 18 patientsThis is a procedure where a cloudy lens in your eye, known as a cataract, is removed. After removal, a clear artificial lens is inserted. This helps to restore your vision, enabling you to see clearly again.
This service was performed 158 times for 90 patientsThis procedure, also known as upper eyelid surgery, is performed to remove excess skin and fat from the upper eyelid. It can help improve vision if heavy eyelids hinder it, and can also enhance the appearance of the eyes. It's a common, safe procedure.
This service was performed 34 times for 17 patientsThis procedure, known as YAG laser capsulotomy, treats cloudiness in the lens capsule following cataract surgery. A laser is used to create a small hole in the cloudy capsule, allowing light to pass through and restore clear vision. It's a quick, painless procedure.
This service was performed 143 times for 91 patientsCLIA 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
- 26D0707725
- Facility Type
- Ambulatory Surgery Center
- Certificate Effective Date
- September 01, 2024
- Certificate Expiration Date
- August 31, 2026
- Laboratory Director
- STEPHEN WILES
- Certificate Type
- Certificate of Waiver
- Certificate Type Description
- This CLIA certificate is issued to Surgery Center Of St. Joseph, 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 1104857523, we treat the final digit (3) 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 57. The final step is to find the difference between that total and the next multiple of ten (60 - 57 = 3).
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 57 is 60. The difference is the calculated check digit.
Other Providers at the Same Location
The following 3 providers are registered at the same or a nearby location.
SAINT JOSEPH, MO 64506
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1104857523, enumerated as an "organization" on July 05, 2006.
The provider is located at 3201 ASHLAND AVE SAINT JOSEPH, MO 64506 and the phone number is (816) 279-0079.
Clinic/Center with taxonomy code 261QA1903X and a focus in Ambulatory Surgical.
The provider might be accepting Accepts: Anthem Blue Cross and Blue Shield, Oscar Insurance. Please consult your insurance carrier or call the provider to verify.
