EXECUTIVE WOODS AMBULATORY SURGERY CENTER LLC
NPI 1265495451
Clinic/Center - Ambulatory Surgical in Albany, NY

Q: What is Executive Woods Ambulatory 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 April 10, 2006CLIA 33D0974859 · Waiver

3 ATRIUM DR, SUITE 150, ALBANY, NY 12205(518) 453-2361(518) 453-1594 Get Directions Write a Review

NPPES record last updated: July 23, 2025. Verified against the NPPES registry weekly; last sync: October 25, 2026.

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About Executive Woods Ambulatory Surgery Center Llc NPPES

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

EXECUTIVE WOODS AMBULATORY SURGERY CENTER LLC (NPI 1265495451) is a healthcare organization registered as an ambulatory surgical in Albany, New York and active in the NPI registry since April 2006. The organization holds a CLIA Waiver certificate valid through March 26, 2027 and lists Kyle R. Flik, Medical Director, as its authorized official.

NPPES Registry Identity

NPI1265495451

Entity TypeOrganization

Primary Taxonomy261QA1903X

Legal Business NameEXECUTIVE WOODS AMBULATORY SURGERY CENTER LLC

Location Address3 ATRIUM DR, SUITE 150Albany, NY 12205-1417

Mailing Address3 Atrium Dr, Suite 150Albany, NY 12205-1417 · (518) 453-2361 · Fax (518) 453-1594

Phone(518) 453-2361

Fax(518) 453-1594

Organization SubpartNo

Authorized OfficialKyle R. FlikMedical Director · (518) 453-2361

Enumeration DateApril 10, 2006

Last NPPES UpdateJuly 23, 2025

NPPES CertifiedJuly 23, 2025

✔ NPI 1265495451 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 in NY · 0101219R

3 ATRIUM DR, Albany, NY 12205

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Other Identifiers 5

Other000401075000NY · Bsneny Provider Number

Other10043997NY · Cdphp Provider Number

Medicaid02107211NY

Other014594NY · Empire Bc Provider Number

Other1488NY · Mvp Provider Number

Medicare Participation & PECOS CMS

Medicare enrollment and revalidation status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Executive Woods Ambulatory Surgery Center Llc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Medicare Revalidation Due Date

Revalidation due by January 31, 2027

Medicare-enrolled providers and suppliers confirm their enrollment information with CMS on a set cycle, every 5 years for most and every 3 years for medical equipment suppliers. CMS sets the due date for each enrollment.

StateEnrollment IDDue date

StateNew YorkEnrollment IDO20111227000704Non-DME Part B · Ambulatory Surgical CenterDue dateJanuary 31, 2027

Source: CMS Revalidation Due Date List, October 2026 release.

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 33D0974859

Executive Woods Ambulatory Surg Ctr LLC Dba Orthony Ambul Surg Ctr - Albany · Albany, NY

Active · expires Mar 26, 2027

CLIA Number33D0974859

Laboratory TypeAmbulatory Surgery Center

Certificate Effective DateJune 20, 2000

Certificate Expiration DateMarch 26, 2027

Laboratory DirectorDr. Adam G. Suslak

Laboratory Phone(518) 453-2361

Laboratory LocationExecutive Woods Ambulatory Surg Ctr LLC Dba Orthony Ambul Surg Ctr - Albany3 Atrium Drive - Suite 150, Albany, NY 12205

CLIA data matches this NPI record on: Address Phone

This certificate is issued to a laboratory to perform only waived tests.

Areas of Expertise CMS Part B claims 14

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.

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.

101 services76 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.

93 services48 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.

91 services77 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.

49 services47 patients

Incision of joint capsule of foot and toe 28270

An incision of the joint capsule of the foot and toe is a procedure where a small cut is made to access the joint capsule in your foot or toe. This is often done to treat conditions like arthritis or injury. It can help to relieve pain and improve mobility.

44 services18 patients

Correction of toe joint deformity 28285

Correction of toe joint deformity is a procedure to fix misshapen toe joints. This can involve realigning the bones, removing bone or tissue, or implanting devices to improve joint function. It can help reduce pain and improve mobility.

33 services16 patients

Prosthetic repair of shoulder joint, total shoulder 23472

Total shoulder prosthetic repair is a surgical procedure to replace a damaged shoulder joint with artificial components. It aims to relieve pain and restore mobility. The procedure involves replacing the ball (humeral head) and socket (glenoid) of the shoulder joint.

29 services29 patients

Removal of extensive shoulder joint tissue using an endoscope 29823

This procedure, known as arthroscopic debridement, involves using a small camera (endoscope) to view your shoulder joint. Damaged or unwanted tissue is then carefully removed. This minimally invasive technique aims to reduce pain and improve joint mobility.

27 services25 patients

Insertion of spinal neurostimulator electrode array through skin 63650

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.

27 services16 patients

Release of tendon connecting biceps muscle and shoulder using an endoscope 29828

This procedure involves using a small camera, known as an endoscope, to view and release the tendon connecting your biceps muscle and shoulder. It can help reduce pain and improve mobility. The procedure is minimally invasive, promoting quicker recovery.

24 services24 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.

24 services12 patients

Removal of deep implant from bone 20680

This procedure involves the careful extraction of an implant deeply embedded in a bone. A specialist makes a small incision, then utilizes precise instruments to reach and safely remove the implant. The area is then closed and monitored for healing.

17 services15 patients

Partial removal of collar bone at shoulder using an endoscope 29824

This procedure involves the partial removal of the collar bone at the shoulder using an endoscope, a tool with a light and camera. It's done to relieve pain or improve shoulder movement. The surgeon makes small incisions, then uses the endoscope to guide their work.

17 services17 patients

Removal of bone joints between wrist and fingers 25447

This procedure involves the surgical removal of bone joints between your wrist and fingers. It's typically done to relieve pain or restore function due to conditions like arthritis. After removal, the space may be filled with a graft or artificial joint.

12 services12 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.

DR. PATRICK J MOTTOLESE D.D.S.

Dentist (General Practice)

3 ATRIUM DR, SUITE 215
ALBANY, NY 12205

Albany County (518) 459-4390

ALBANY TROY CATARACT & LASER ASSOCIATES

Eyewear Supplier

3 ATRIUM DR, SUITE 100
ALBANY, NY 12205

Albany County (518) 438-5273

UPSTATE NEUROLOGY CONSULTANTS LLP

Psychiatry & Neurology (Neurology)

3 ATRIUM DR, SUITE 200
ALBANY, NY 12205

Albany County (518) 438-0922

DR. HEATHER L. DEERE OD

Optometrist

3 ATRIUM DR, SUITE 100
ALBANY, NY 12205

Albany County (518) 438-5273

DR. MANIJEH CONTRACTOR M.D

Ophthalmology (Neuro-ophthalmology)

3 ATRIUM DR, SUITE 100
ALBANY, NY 12205

Albany County (518) 438-5273

DR. NICHOLAS WILLIAM VEROLA M.D.

Ophthalmology

3 ATRIUM DR, SUITE 100
ALBANY, NY 12205

Albany County (518) 438-5273

THOMAS NICCOLLA CONSULTING SERVICES, PLLC

Clinic/Center (Physical Therapy)

3 ATRIUM DR, SUITE 110
ALBANY, NY 12205

Albany County (518) 482-1748

ERIK CARMAN

Physical Therapist

3 ATRIUM DR
ALBANY, NY 12205

Albany County (518) 577-2228

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 Executive Woods Ambulatory Surgery Center LLC's NPI number?

The NPI number for Executive Woods Ambulatory Surgery Center LLC is 1265495451. It was assigned to this organization in the NPPES registry on April 10, 2006.

Where is Executive Woods Ambulatory Surgery Center LLC located?

Executive Woods Ambulatory Surgery Center LLC is located at 3 Atrium Dr Suite 150, Albany, NY 12205. The listed phone number is (518) 453-2361.

What is Executive Woods Ambulatory Surgery Center LLC's specialty?

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

Is Executive Woods Ambulatory Surgery Center LLC enrolled in Medicare?

Yes. Executive Woods Ambulatory Surgery Center LLC is registered in the Medicare PECOS enrollment system.

When is Executive Woods Ambulatory Surgery Center LLC's Medicare revalidation due?

According to the CMS Revalidation Due Date List (October 2026 release), the Medicare Non-DME Part B enrollment for this organization (New York, Ambulatory Surgical Center) is due for revalidation by January 31, 2027. Medicare providers and suppliers revalidate their enrollment every 5 years, and medical equipment suppliers every 3 years. Confirm current requirements with your Medicare Administrative Contractor.

Does Executive Woods Ambulatory Surgery Center LLC hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 33D0974859) is associated with this NPI, valid through March 26, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Executive Woods Ambulatory Surgery Center LLC was last updated on July 23, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 15 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.

About Executive Woods Ambulatory Surgery Center Llc NPPES

NPPES Registry Identity

Specialties & Licenses

Other Identifiers 5

Medicare Participation & PECOS CMS

Medicare Enrollment Status

Medicare Revalidation Due Date

CLIA Laboratory Certificates CMS CLIA

Certificate of Waiver · 33D0974859

Areas of Expertise CMS Part B claims 14

Other Providers at the Same Location NPPES 20

Frequently Asked Questions NPPES & CMS

What is Executive Woods Ambulatory Surgery Center LLC's NPI number?

Where is Executive Woods Ambulatory Surgery Center LLC located?

What is Executive Woods Ambulatory Surgery Center LLC's specialty?

Is Executive Woods Ambulatory Surgery Center LLC enrolled in Medicare?

When is Executive Woods Ambulatory Surgery Center LLC's Medicare revalidation due?

Does Executive Woods Ambulatory Surgery Center LLC hold a CLIA laboratory certificate?

When was this NPI record last updated?

Certificate of Waiver 33D0974859