WEST LAKES SURGERY CENTER LLC
NPI 1104933696
Clinic/Center - Ambulatory Surgical in Clive, IA

Q: What is West Lakes Surgery Center LLC's NPI number?

The NPI number for West Lakes Surgery Center LLC is 1104933696. It was assigned to this organization in the NPPES registry on August 23, 2006.

Q: What is West Lakes Surgery Center LLC's specialty?

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

Active since August 23, 2006CLIA 16D1058574 · Waiver

12499 UNIVERSITY AVE, SUITE 100, CLIVE, IA 50325(515) 974-5050 Get Directions Write a Review

NPPES record last updated: June 4, 2020. Verified against the NPPES registry weekly; last sync: August 09, 2026.

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About West Lakes Surgery Center Llc NPPES

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

WEST LAKES SURGERY CENTER LLC (NPI 1104933696) is a healthcare organization registered as an ambulatory surgical in Clive, Iowa and active in the NPI registry since August 2006. The organization holds a CLIA Waiver certificate valid through September 7, 2026 and lists Teri S Formanek, President, as its authorized official.

NPPES Registry Identity

NPI1104933696

Entity TypeOrganization

Primary Taxonomy261QA1903X

Legal Business NameWEST LAKES SURGERY CENTER LLC

Location Address12499 UNIVERSITY AVE, SUITE 100Clive, IA 50325-8281

Mailing Address2808 S Ingram Mill Rd, Building BSpringfield, MO 65804-4042 · (417) 889-2040 · Fax (417) 889-2041

Phone(515) 974-5050

Organization SubpartNo

Authorized OfficialTeri S FormanekPresident · (515) 327-1555

Enumeration DateAugust 23, 2006

Last NPPES UpdateJune 4, 2020

NPPES CertifiedJune 4, 2020

✔ NPI 1104933696 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 · NA

12499 UNIVERSITY AVE, Clive, IA 50325

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Other Identifiers 7

OtherF252394IA · Cigna

Other61026IA · Wellmark Bcbs

OtherF252394IA · Carpenters District Coun

Medicaid0610352IA

Other61026IA · Federal Employees Health

OtherF252394IA · Midlands Aetna

Other61026IA · Wellmark Health Plans Ia

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Medica, Oscar Insurance Company, UnitedHealthcare.Insurance ›

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 16D1058574

West Lakes Surgery Center,llc · Clive, IA

Active · expires Sep 7, 2026

CLIA Number16D1058574

Laboratory TypeAmbulatory Surgery Center

Certificate Effective DateSeptember 8, 2024

Certificate Expiration DateSeptember 7, 2026

Laboratory DirectorTeri S. Formanek

Laboratory Phone(515) 974-5050

Laboratory LocationWest Lakes Surgery Center,llc12499 University Avenue, Suite 100, Clive, IA 50325

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 32

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.

Injection, bupivacaine liposome, 1 mg C9290

Bupivacaine liposome is a local anesthetic used to numb a specific area of the body and reduce pain or discomfort associated with surgical procedures. The 1 mg dosage is injected by a healthcare professional at the required site.

3,658 services27 patients

Instillation, bupivacaine and meloxicam, 1 mg/0.03 mg C9088

Instillation of bupivacaine and meloxicam involves administering these medications into your body, usually through an injection. Bupivacaine is a local anesthetic that numbs specific areas, and meloxicam is an anti-inflammatory drug that reduces pain and swelling.

415 services11 patients

Injection of lower or sacral spine facet joint using imaging guidance, single level 64493

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.

299 services105 patients

Injection of anesthetic and/or steroid drug into sacral spine nerve root using imaging guidance, single level 64483

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.

213 services143 patients

Destruction of lower or sacral spinal facet joint nerves using imaging guidance, single facet joint 64635

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.

199 services111 patients

Injection procedure for sacroiliac joint; provision of anesthetic, steroid and/or other therapeutic agent, with or without arthrography G0260

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.

181 services78 patients

Injection of substance into lower spine canal using imaging guidance 62323

This procedure involves injecting a substance into your lower spine canal, guided by real-time images. It's done to diagnose or treat various conditions. You may feel slight discomfort, but it's generally safe and can provide valuable information for your treatment plan.

146 services119 patients

Aspiration and/or injection of fluid from large joint 20610

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.

59 services43 patients

Removal of excessive skin and fat of upper eyelid 15823

This 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.

57 services29 patients

Injection of substance into middle or upper spine canal using imaging guidance 62321

This procedure involves injecting a substance into your middle or upper spine canal. It's performed under imaging guidance to ensure accuracy. The substance can help diagnose or treat various conditions, providing relief from symptoms.

55 services46 patients

Injection of trigger points, 3 or more muscles 20553

Trigger point injection therapy involves injecting medication into specific areas of your muscles, known as trigger points. These are areas that produce pain and discomfort. If you have three or more muscles affected, each will be treated individually.

53 services44 patients

Repair of brow paralysis 67900

Repair of brow paralysis is a procedure aimed to restore function and symmetry to the face. This is achieved by adjusting muscles and nerves in the brow area. It can help improve the appearance and movement of the forehead and eyebrows, enhancing overall facial expressions.

52 services26 patients

Complete laser vaporization of prostate including control of bleeding using an endoscope 52648

This procedure involves using a special light instrument to carefully remove tissue from a gland located in the lower body. This helps improve the flow of body fluids. The process is done through a tube-like device and also controls any bleeding.

44 services44 patients

Injection of upper or middle spine facet joint using imaging guidance, single level 64490

This procedure involves injecting medication into a joint in your upper or middle spine. It's performed under imaging guidance for precision. The aim is to reduce inflammation and pain. It's a single-level process, meaning one joint is treated at a time.

43 services21 patients

Injection of trigger points, 1-2 muscles 20552

Trigger point injection is a procedure used to treat painful areas of muscle that contain trigger points, or knots of muscle that form when muscles do not relax. 1-2 muscles are typically treated in one session. The procedure involves injecting medications into these points to alleviate pain.

40 services36 patients

Crushing of stone of ureter with insertion of stent using an endoscope 52356

This procedure involves using a thin, flexible tube (endoscope) to locate and break down kidney stones in the ureter. After this, a small tube (stent) is inserted to help maintain an open pathway for urine to flow.

38 services34 patients

Insertion of stent in ureter using an endoscope 52332

This procedure involves placing a small, flexible tube (stent) in your body's drainage system to help urine flow from the kidneys to the bladder. An endoscope, a thin tube with a light and camera, is used for precise placement.

35 services28 patients

Replacement of knee joint, both sides of knee 27447

A bilateral knee joint replacement is a procedure where the damaged parts of both your knee joints are replaced with artificial parts. It aims to relieve pain and improve mobility. The process involves a surgical operation under anesthesia.

27 services23 patients

Removal of nasal sinus tissue using an endoscope 31267

This procedure, known as endoscopic sinus surgery, involves using a thin, flexible tube with a light and camera to view and remove problematic nasal sinus tissue. It helps to alleviate sinus issues and improve breathing.

26 services25 patients

Destruction of upper or middle spinal facet joint nerves using imaging guidance, single facet joint 64633

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.

22 services17 patients

Injection of anesthetic agent and/or steroid into upper neck and back of head nerve 64405

This procedure involves injecting a mix of anesthetic and/or steroid into nerves in the upper neck and back of the head. It helps relieve pain by reducing inflammation and numbing the area. It's a common treatment for headaches and neck pain.

21 services12 patients

Shock wave crushing of kidney stones 50590

Shock wave crushing of kidney stones, also known as Extracorporeal Shock Wave Lithotripsy (ESWL), is a non-invasive treatment. It involves the use of sound waves to break down kidney stones into small pieces that can easily pass through your urinary tract.

19 services18 patients

Creation of sling around urethra in female to control leakage 57288

This procedure involves creating a supportive loop around a tube in your lower body that carries liquid waste. This helps manage any unwanted leakage, providing you with better control and comfort.

19 services19 patients

Removal of nasal air passage under lining tissue 30140

This procedure, often done to improve breathing or address sinus issues, involves the removal of tissue from the lining of the nasal air passage. It's performed under anesthesia and recovery time varies based on individual health status.

18 services18 patients

Repair of shoulder rotator cuff using an endoscope 29827

This procedure, known as arthroscopic rotator cuff repair, helps fix tears in the shoulder's rotator cuff. An endoscope, a small camera, is used to view the shoulder inside. Using small tools, the surgeon repairs the torn tissue. This minimally invasive approach often leads to a quicker recovery.

16 services16 patients

Reshaping of nasal cartilage 30520

Reshaping of nasal cartilage, also known as rhinoplasty, is a surgical procedure to modify the structure of the nose for aesthetic or functional purposes. It involves adjusting the cartilage and bone in the nose to achieve the desired shape or to improve breathing.

16 services16 patients

Destruction of surface soft tissue of nasal passages 30802

This procedure involves removing or destroying soft tissue in the nasal passages. It's often performed to improve breathing, reduce snoring, or treat conditions like nasal polyps. The process is usually done under local or general anesthesia.

15 services15 patients

Complete exam of nose and sinuses using an endoscope 31253

This procedure involves inserting a thin tube with a light (endoscope) into the nose to examine the nasal passages and sinuses. It helps identify any abnormalities or issues. The process is safe, usually painless, and provides valuable information for your care.

15 services13 patients

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.

14 services13 patients

Removal of bone from lower spine for decompression of nerve tissue using imaging guidance, accessed through the skin 0275T

This procedure involves removing a small portion of bone from your lower spine. The goal is to relieve pressure on your nerve tissue, improving comfort and mobility. It is done through the skin using imaging technology to ensure precision and safety.

13 services13 patients

Removal of knee cartilage using an endoscope 29881

This procedure, known as arthroscopic knee surgery, involves using a small camera (endoscope) to view the inside of your knee. Small instruments are used to remove damaged cartilage. This can help alleviate pain and improve knee function.

13 services13 patients

Correction of bunion with alignment correction of midfoot bone toward toe area 28296

This procedure corrects a bunion, a bony bump forming at the base of your big toe. It involves realigning the midfoot bone towards the toe area to restore the natural shape of your foot. This can alleviate discomfort and improve foot function.

11 services11 patients

Other Providers at the Same Location NPPES 20

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

WILLIAM R. BOULDEN MD PC

Orthopaedic Surgery

12499 UNIVERSITY AVE, SUITE 210
DES MOINES, IA 50325

Polk County (515) 440-2676

MRS. DIANA ELIZABETH HANSON MS, CCC-A

Audiologist

12499 UNIVERSITY AVE, STE 200
CLIVE, IA 50325

Polk County (515) 418-9960

MS. SARAH M FUGLEBERG

Audiologist

12499 UNIVERSITY AVE, STE 200
CLIVE, IA 50325

Polk County (515) 418-9960

DR. DONNA J BAHLS M.D.

Physical Medicine & Rehabilitation

12499 UNIVERSITY AVE, SUITE 210
CLIVE, IA 50325

Polk County (515) 327-1555

EMILY BOWERS ARNP

Nurse Practitioner

12499 UNIVERSITY AVE
CLIVE, IA 50325

Polk County (515) 245-6425

DELANEY THOMAS

Hearing Instrument Specialist

12499 UNIVERSITY AVE
CLIVE, IA 50325

Polk County (515) 418-9960

DR. BRIAN M CRITES M.D.

Orthopaedic Surgery

12499 UNIVERSITY AVE, SUITE 210
CLIVE, IA 50325

Polk County (515) 440-2676

BETH JOANN MACPHERSON M.A.

Audiologist

12499 UNIVERSITY AVE, SUITE 200
CLIVE, IA 50325

Polk County (515) 418-9960

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 West Lakes Surgery Center LLC's NPI number?

The NPI number for West Lakes Surgery Center LLC is 1104933696. It was assigned to this organization in the NPPES registry on August 23, 2006.

Where is West Lakes Surgery Center LLC located?

West Lakes Surgery Center LLC is located at 12499 University Ave Suite 100, Clive, IA 50325. The listed phone number is (515) 974-5050.

What is West Lakes Surgery Center LLC's specialty?

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

Does West Lakes Surgery Center LLC hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 16D1058574) is associated with this NPI, valid through September 7, 2026. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

What insurance does West Lakes Surgery Center LLC accept?

Health plans from Medica, Oscar Insurance Company and UnitedHealthcare list West Lakes Surgery Center 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 West Lakes Surgery Center LLC was last updated on June 4, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 years 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.

About West Lakes Surgery Center Llc NPPES

NPPES Registry Identity

Specialties & Licenses

Other Identifiers 7

Accepted Insurance

CLIA Laboratory Certificates CMS CLIA

Certificate of Waiver · 16D1058574

Areas of Expertise CMS Part B claims 32

Other Providers at the Same Location NPPES 20

Frequently Asked Questions NPPES & CMS

What is West Lakes Surgery Center LLC's NPI number?

Where is West Lakes Surgery Center LLC located?

What is West Lakes Surgery Center LLC's specialty?

Does West Lakes Surgery Center LLC hold a CLIA laboratory certificate?

What insurance does West Lakes Surgery Center LLC accept?

When was this NPI record last updated?

Certificate of Waiver 16D1058574