EXECUTIVE AMBULATORY SURGICAL CENTER, LLC
NPI 1386056356
Clinic/Center - Ambulatory Surgical in Dearborn, MI

Active since May 27, 2014CLIA 23D2083095 · Waiver
17000 EXECUTIVE PLAZA DR, SUITE 301, DEARBORN, MI 48126(313) 408-6613 Get Directions Write a Review

NPPES record last updated: November 20, 2025. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Executive Ambulatory Surgical Center, Llc NPPES

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

EXECUTIVE AMBULATORY SURGICAL CENTER, LLC (NPI 1386056356) is a healthcare organization registered as an ambulatory surgical in Dearborn, Michigan and active in the NPI registry since May 2014. The organization holds a CLIA Waiver certificate valid through August 27, 2026 and lists Samer Suleiman, Manager, as its authorized official.

NPPES Registry Identity

NPI1386056356
Entity TypeOrganization
Primary Taxonomy261QA1903X
Legal Business NameEXECUTIVE AMBULATORY SURGICAL CENTER, LLC
Location Address17000 EXECUTIVE PLAZA DR, SUITE 301Dearborn, MI 48126-2793
Mailing Address17000 Executive Plaza Dr Ste 301Dearborn, MI 48126-2793 · (313) 789-5579 · Fax (313) 789-5589
Organization SubpartNo
Authorized OfficialSamer SuleimanManager · (313) 789-5579
Enumeration DateMay 27, 2014
Last NPPES UpdateNovember 20, 2025
NPPES CertifiedNovember 20, 2025
NPI 1386056356 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyClinic/Center · Ambulatory SurgicalAmbulatory Health Care Facilities
Taxonomy Code261QA1903X
17000 EXECUTIVE PLAZA DR, Dearborn, MI 48126

Accepted 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 23D2083095

Executive Ambulatory Surgical Center, LLC · Dearborn, MI
Active · expires Aug 27, 2026
CLIA Number23D2083095
Laboratory TypeAmbulatory Surgery Center
Certificate Effective DateAugust 28, 2024
Certificate Expiration DateAugust 27, 2026
Laboratory DirectorRakesh Ramakrishnan
Laboratory Phone(313) 408-6613
Laboratory LocationExecutive Ambulatory Surgical Center, LLC17000 Executive Plaza Drive, Suite 301, Dearborn, MI 48126
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

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 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.
13 services11 patients

Other Providers at the Same Location NPPES 11

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

Physical Therapist
17000 EXECUTIVE PLAZA DR
DEARBORN, MI 48126
Clinic/Center (Multi-Specialty)
17000 EXECUTIVE PLAZA DR, SUITE 106
DEARBORN, MI 48126
Clinic/Center (Infusion Therapy)
17000 EXECUTIVE PLAZA DR, SUITE 201
DEARBORN, MI 48126
Physical Medicine & Rehabilitation
17000 EXECUTIVE PLAZA DR
DEARBORN, MI 48126
Pharmacy (Long Term Care Pharmacy)
17000 EXECUTIVE PLAZA DR, SUITE 104
DEARBORN, MI 48126
Pharmacy (Home Infusion Therapy Pharmacy)
17000 EXECUTIVE PLAZA DR, SUITE 201-A
DEARBORN, MI 48126
Clinical Medical Laboratory
17000 EXECUTIVE PLAZA DR, SUITE 202
DEARBORN, MI 48126
Clinic/Center (Magnetic Resonance Imaging (MRI))
17000 EXECUTIVE PLAZA DR
DEARBORN, MI 48126

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 Ambulatory Surgical Center, LLC's NPI number?

The NPI number for Executive Ambulatory Surgical Center, LLC is 1386056356. It was assigned to this organization in the NPPES registry on May 27, 2014.

Where is Executive Ambulatory Surgical Center, LLC located?

Executive Ambulatory Surgical Center, LLC is located at 17000 Executive Plaza Dr Suite 301, Dearborn, MI 48126. The listed phone number is (313) 408-6613.

What is Executive Ambulatory Surgical Center, LLC's specialty?

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

Does Executive Ambulatory Surgical Center, LLC hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 23D2083095) is associated with this NPI, valid through August 27, 2026. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

What insurance does Executive Ambulatory Surgical 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 Executive Ambulatory Surgical 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 Executive Ambulatory Surgical Center, LLC was last updated on November 20, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 8 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.