GOOD SAMARITAN SURGERY CENTER
NPI 1285980151
Clinic/Center - Ambulatory Surgical in Mount Vernon, IL
NPI Status: Active since July 30, 2012
Contact Information
2 GOOD SAMARITAN WAY
STE 200
MOUNT VERNON, IL
ZIP 62864
Phone: (618) 899-5703
Fax: (618) 899-5704
- Organization
- Clinic/Center
- Ambulatory Surgical
- CLIA Number: 14D2047582
- CLIA Cert. Type: Ambulatory Surgery Center
- CLIA Exp. Date: 09-25-2026
About GOOD SAMARITAN SURGERY CENTER
This page provides the complete NPI Profile along with additional information for Good Samaritan Surgery Center, a provider established in Mount Vernon, Illinois operating as a Clinic/center, focusing in ambulatory surgical . The healthcare provider is registered in the NPI registry with number 1285980151 assigned on July 2012. The practitioner's primary taxonomy code is 261QA1903X with license number 7003172 (IL). The provider is registered as an organization and their NPI record was last updated one year ago. The provider's is doing business as Good Samaritan Surgery Center. The authorized official of this NPI record is Joon Ahn Md (Authorized Official - Owner)
- NPI
- 1285980151
- Provider Legal Name
- PHYSICIANS SURGERY CENTER AT GOOD SAMARITAN, LLC
- Other Organization Name
- GOOD SAMARITAN SURGERY CENTER
- Other Name Type
- Doing Business As (3)
- Entity Type
- Organization
- Location Address
- 2 GOOD SAMARITAN WAY STE 200 MOUNT VERNON, IL 62864
- Location Phone
- (618) 899-5703
- Location Fax
- (618) 899-5704
- Mailing Address
- 2 GOOD SAMARITAN WAY STE 200 MOUNT VERNON, IL 62864
- Mailing Phone
- (618) 899-5703
- Mailing Fax
- (618) 899-5704
- Is Sole Proprietor?
- No
- Is Organization Subpart?
- No
- Enumeration Date
- 07-30-2012
- Last Update Date
- 01-08-2025
- 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.
- 7003172
- License State
- IL
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.
Crushing of stone of ureter with insertion of stent using an endoscope
Exam with injections of chemical for destruction of bladder using an endoscope
Imaging guidance for procedure, 60 minutes or less
Imaging of urinary tract following injection of a contrast agent
Injection of substance into lower spine canal using imaging guidance
Injection procedure for sacroiliac joint; provision of anesthetic, steroid and/or other therapeutic agent, with or without arthrography
Injection, onabotulinumtoxina, 1 unit
Release of wrist ligament using an endoscope
Removal of cataract with insertion of prosthetic lens
Removal of polyps or growths of large bowel using a flexible endoscope with electrical cautery
Removal of recurring cataract in lens capsule using a laser
Repair of shoulder rotator cuff using an endoscope
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.
This service was performed 28 times for 23 patientsThis procedure involves the use of a thin, flexible tube with a light (endoscope) for internal examination. A chemical is then injected to help eliminate specific issues in the bladder. It's a standard and safe process.
This service was performed 26 times for 26 patientsImaging guidance is a procedure where real-time images are used to direct medical tools during a treatment. This technique helps to improve accuracy and safety. The procedure typically lasts 60 minutes or less.
This service was performed 13 times for 12 patientsThis procedure involves injecting a contrast agent into your body to help highlight the urinary tract during imaging. The contrast agent makes your urinary tract more visible on the images, providing detailed information about its structure and function. This can help in diagnosing any potential issues.
This service was performed 48 times for 41 patientsThis 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.
This service was performed 38 times for 29 patientsThis 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.
This service was performed 23 times for 12 patientsOnabotulinumtoxina, also known as Botox, is a medication injected into muscles. It's used to treat various conditions by blocking nerve activity in the muscles, causing a temporary reduction in muscle activity. The units refer to the dosage.
This service was performed 4,101 times for 26 patientsThis procedure involves using a small camera, called an endoscope, to view and treat a tight wrist ligament. The endoscope is inserted through a tiny incision, reducing recovery time and scarring. It helps to relieve pain and improve wrist function.
This service was performed 64 times for 50 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 253 times for 142 patientsThis procedure involves using a flexible tube with a camera, called an endoscope, to view the large intestine. If any abnormal growths or polyps are found, they are removed with an electrically-heated instrument. This is a common way to prevent bowel issues.
This service was performed 11 times for 11 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 18 times for 13 patientsThis 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.
This service was performed 28 times for 28 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
- 14D2047582
- Facility Type
- Ambulatory Surgery Center
- Certificate Effective Date
- September 26, 2024
- Certificate Expiration Date
- September 25, 2026
- Laboratory Director
- STEVE ROODMAN M D
- Certificate Type
- Certificate of Waiver
- Certificate Type Description
- This CLIA certificate is issued to Good Samaritan Surgery Center 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 1285980151, we treat the final digit (1) 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 59. The final step is to find the difference between that total and the next multiple of ten (60 - 59 = 1).
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 59 is 60. The difference is the calculated check digit.
Other Providers at the Same Location
The following 20 providers are registered at the same or a nearby location.
MOUNT VERNON, IL 62864
MOUNT VERNON, IL 62864
MOUNT VERNON, IL 62864
MOUNT VERNON, IL 62864
MOUNT VERNON, IL 62864
MOUNT VERNON, IL 62864
MOUNT VERNON, IL 62864
MOUNT VERNON, IL 62864
MOUNT VERNON, IL 62864
MOUNT VERNON, IL 62864
MOUNT VERNON, IL 62864
MOUNT VERNON, IL 62864
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1285980151, enumerated as an "organization" on July 30, 2012.
The provider is located at 2 GOOD SAMARITAN WAY STE 200 MOUNT VERNON, IL 62864 and the phone number is (618) 899-5703.
Clinic/Center with taxonomy code 261QA1903X and a focus in Ambulatory Surgical.