GRAND RIVER SURGERY CENTER, LLC
NPI 1124605910
Clinic/Center - Ambulatory Surgical in East Lansing, MI

Q: What is Grand River Surgery Center, LLC's NPI number?

The NPI number for Grand River Surgery Center, LLC is 1124605910. It was assigned to this organization in the NPPES registry on March 26, 2021.

Q: What is Grand River 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 March 26, 2021CLIA 23D2217788 · Waiver

1090 TROWBRIDGE RD STE A, EAST LANSING, MI 48823(517) 220-0240(517) 200-4455 Get Directions Write a Review

NPPES record last updated: December 8, 2021. Verified against the NPPES registry weekly; last sync: August 16, 2026.

Record update history: Dec 8, 2021, May 6, 2021, Mar 26, 2021 (3 updates tracked since 2021).

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About Grand River Surgery Center, Llc NPPES

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

GRAND RIVER SURGERY CENTER, LLC (NPI 1124605910) is a healthcare organization registered as an ambulatory surgical in East Lansing, Michigan and active in the NPI registry since March 2021. The organization holds a CLIA Waiver certificate valid through March 23, 2027 and lists Douglas Dietzel, Ceo, as its authorized official.

NPPES Registry Identity

NPI1124605910

Entity TypeOrganization

Primary Taxonomy261QA1903X

Legal Business NameGRAND RIVER SURGERY CENTER, LLC

Location Address1090 TROWBRIDGE RD STE AEast Lansing, MI 48823-5220

Mailing Address1090 Trowbridge Rd Ste AEast Lansing, MI 48823-5220 · (517) 282-0851

Phone(517) 220-0240

Fax(517) 200-4455

Organization SubpartNo

Authorized OfficialDouglas DietzelCeo · (517) 488-8800

Enumeration DateMarch 26, 2021

Last NPPES UpdateDecember 8, 20213 updates tracked since enumeration

NPPES CertifiedDecember 8, 2021

✔ NPI 1124605910 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyClinic/Center · Ambulatory SurgicalAmbulatory Health Care Facilities

Taxonomy Code261QA1903X

1090 TROWBRIDGE RD STE A, East Lansing, MI 48823

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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 ›

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 23D2217788

Grand River Surgery Center, LLC · East Lansing, MI

Active · expires Mar 23, 2027

CLIA Number23D2217788

Laboratory TypeAmbulatory Surgery Center

Certificate Effective DateMarch 24, 2025

Certificate Expiration DateMarch 23, 2027

Laboratory DirectorAhmed Sufyan

Laboratory Phone(517) 282-0851

Laboratory LocationGrand River Surgery Center, LLC1090 Trowbridge Road Suite A, East Lansing, MI 48823

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 6

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.

4,921 services23 patients

Full thickness skin graft to nose, ears, eyelids, or lips, 20.0 sq cm or less 15260

A full thickness skin graft is a procedure where a layer of skin is taken from one area of the body and transplanted to another. If it's done on the nose, ears, eyelids, or lips, it helps restore these areas when damaged. The size of the graft is 20.0 sq cm or less.

19 services19 patients

Incision of tendon covering of finger 26055

This procedure involves making a small cut into the protective sheath around a finger tendon. It's typically done to relieve pressure or inflammation, improve finger movement, or treat conditions like trigger finger. It's a safe, often outpatient procedure.

19 services15 patients

Release and/or relocation of hand nerve 64721

This procedure involves adjusting or moving a nerve in your hand to alleviate discomfort or improve function. The nerve may be compressed, causing pain or numbness. By releasing or relocating the nerve, these symptoms can be reduced, enhancing hand usage.

17 services16 patients

Preparation of skin graft site of face, scalp, eyelids, mouth, neck, ears, around eyes, genitals, hands, feet, fingers, or toes, 100.0 sq cm or 1% body area for infants and children, or less 15004

This procedure involves preparing a specific area of your body, such as the face, scalp, neck, or extremities, for a skin graft. A skin graft is a surgical procedure where healthy skin is transferred to an area of the body that has lost skin. This preparation ensures the graft will take hold effectively.

14 services14 patients

Repair of wound of eyelids, nose, ears, or lips by transferring skin, 10.0 sq cm or less 14060

This procedure involves repairing a wound on the eyelids, nose, ears, or lips by moving a small piece of skin (10.0 sq cm or less) from one area to another. The goal is to heal the wound and restore the function and appearance of the affected area.

13 services13 patients

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 Grand River Surgery Center, LLC's NPI number?

The NPI number for Grand River Surgery Center, LLC is 1124605910. It was assigned to this organization in the NPPES registry on March 26, 2021.

Where is Grand River Surgery Center, LLC located?

Grand River Surgery Center, LLC is located at 1090 Trowbridge Rd Ste A, East Lansing, MI 48823. The listed phone number is (517) 220-0240.

What is Grand River Surgery Center, LLC's specialty?

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

Does Grand River Surgery Center, LLC hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 23D2217788) is associated with this NPI, valid through March 23, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

What insurance does Grand River Surgery Center, LLC accept?

Health plans from Ambetter Health, Ambetter from Buckeye Health Plan, Ambetter from Meridian, Blue Care Network of Michigan and Blue Cross Blue Shield of Michigan Mutual Insurance Company and 2 other insurers list Grand River 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 Grand River Surgery Center, LLC was last updated on December 8, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 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.