EXECUTIVE AMBULATORY SURGICAL CENTER, LLC
NPI 1386056356
Clinic/Center - Ambulatory Surgical in Dearborn, MI
NPI Status: Active since May 27, 2014
Contact Information
17000 EXECUTIVE PLAZA DR
SUITE 301
DEARBORN, MI
ZIP 48126
Phone: (313) 408-6613
- Organization
- Clinic/Center
- Ambulatory Surgical
- Accepts Insurance
- CLIA Number: 23D2083095
- CLIA Cert. Type: Ambulatory Surgery Center
- CLIA Exp. Date: 08-27-2026
About EXECUTIVE AMBULATORY SURGICAL CENTER, LLC
This page provides the complete NPI Profile along with additional information for Executive Ambulatory Surgical Center, Llc, a provider established in Dearborn, Michigan operating as a Clinic/center, focusing in ambulatory surgical . The healthcare provider is registered in the NPI registry with number 1386056356 assigned on May 2014. The practitioner's primary taxonomy code is 261QA1903X. The provider is registered as an organization and their NPI record was last updated one year ago. The authorized official of this NPI record is Samer Suleiman (Manager)
- NPI
- 1386056356
- Provider Name
- EXECUTIVE AMBULATORY SURGICAL CENTER, LLC
- Entity Type
- Organization
- Location Address
- 17000 EXECUTIVE PLAZA DR SUITE 301 DEARBORN, MI 48126
- Location Phone
- (313) 408-6613
- Mailing Address
- 17000 EXECUTIVE PLAZA DR STE 301 DEARBORN, MI 48126
- Mailing Phone
- (313) 789-5579
- Mailing Fax
- Is Sole Proprietor?
- No
- Is Organization Subpart?
- No
- Enumeration Date
- 05-27-2014
- Last Update Date
- 11-20-2025
- 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
Insurance Plans Accepted
According to publicly available information the provider might be accepting the following health plans from these health insurance companies:
- Choice Bronze HSA - HMO
- Choice Bronze HSA + Vision + Adult Dental - HMO
- Clear Gold - HMO
- Clear Gold + Vision + Adult Dental - HMO
- Complete Gold - HMO
- Complete Gold + Vision + Adult Dental - HMO
- Complete Silver - HMO
- Complete Silver + Vision + Adult Dental - HMO
- Everyday Bronze - HMO
- Everyday Bronze + Vision + Adult Dental - HMO
- Clear Silver - HMO
- Elite Gold - HMO
- Elite Gold + Vision + Adult Dental - HMO
- Everyday Gold - HMO
- Everyday Gold + Vision + Adult Dental - HMO
- Standard Gold - HMO
- Standard Gold + Vision + Adult Dental - HMO
- Standard Silver - HMO
- Standard Silver + Vision + Adult Dental - HMO
- Complete Gold - HMO
- Complete Gold + Vision + Adult Dental - HMO
- Elite Gold - HMO
- Elite Gold + Vision + Adult Dental - HMO
- Focused Silver - HMO
- Focused Silver + Vision + Adult Dental - HMO
- Standard Gold - HMO
- Standard Gold + Vision + Adult Dental - HMO
- Standard Silver - HMO
- Standard Silver + Vision + Adult Dental - HMO
- Blue Cross� Local HMO Bronze Extra - HMO
- Blue Cross� Local HMO Bronze Secure - HMO
- Blue Cross� Local HMO Silver Extra - HMO
- Blue Cross� Local HMO Silver Saver - HMO
- Blue Cross� Preferred HMO Bronze Extra - HMO
- Blue Cross� Preferred HMO Bronze Saver HSA - HMO
- Blue Cross� Preferred HMO Bronze Secure - HMO
- Blue Cross� Preferred HMO Gold - HMO
- Blue Cross� Preferred HMO Gold Extra - HMO
- Blue Cross� Preferred HMO Silver - HMO
- Blue Cross� Premier PPO Bronze Extra - PPO
- Blue Cross� Premier PPO Bronze Saver HSA - PPO
- Blue Cross� Premier PPO Bronze Secure - PPO
- Blue Cross� Premier PPO Gold - PPO
- Blue Cross� Premier PPO Gold Extra - PPO
- Blue Cross� Premier PPO Silver - PPO
- Blue Cross� Premier PPO Silver Extra - PPO
- Blue Cross� Premier PPO Silver Saver HSA - PPO
- Blue Cross� Premier PPO Value - PPO
- MyPriority Balanced Silver - HMO
- MyPriority Balanced Silver Southeast Michigan Network - HMO
- MyPriority Balanced Silver Trinity Health East Network - HMO
- MyPriority Enhanced Gold Southeast Michigan Network - HMO
- MyPriority Enhanced Gold Trinity Health East Network - HMO
- MyPriority Premier Silver - HMO
- MyPriority Premier Silver Trinity Health East Network - HMO
- MyPriority Standard Bronze - HMO
- MyPriority Standard Bronze - Southeast Michigan Network - HMO
- MyPriority Standard Bronze - Travel - HMO
- UHC Bronze Copay Focus (No Referrals) - HMO
- UHC Bronze Essential (No Referrals) - HMO
- UHC Bronze Essential+ (Dental + Vision, No Referrals) - HMO
- UHC Bronze Standard (No Referrals) - HMO
- UHC Gold Advantage (No Referrals) - HMO
- UHC Gold Advantage+ (Dental + Vision, No Referrals) - HMO
- UHC Gold Copay Focus (No Referrals) - HMO
- UHC Gold Standard (No Referrals) - HMO
- UHC Silver Advantage (No Referrals) - HMO
- UHC Silver Advantage+ (Dental + Vision, No Referrals) - HMO
*Please verify directly with this provider to make sure your insurance plan is currently accepted.
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.
Injection of anesthetic and/or steroid drug into sacral spine nerve root using imaging guidance, single level
Injection of substance into lower spine canal using imaging guidance
Removal of joint lining from multiple knee joint compartments using an endoscope
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.
This service was performed 14 times for 11 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 29 times for 19 patientsThis procedure, called a synovectomy, involves using an endoscope, a small camera, to view your knee joint. The surgeon then removes the inflamed joint lining from several areas of your knee. The goal is to reduce pain and improve joint function.
This service was performed 12 times for 11 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
- 23D2083095
- Facility Type
- Ambulatory Surgery Center
- Certificate Effective Date
- August 28, 2024
- Certificate Expiration Date
- August 27, 2026
- Laboratory Director
- RAKESH RAMAKRISHNAN
- Certificate Type
- Certificate of Waiver
- Certificate Type Description
- This CLIA certificate is issued to Executive Ambulatory Surgical Center, Llc 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.
Reviews for EXECUTIVE AMBULATORY SURGICAL CENTER, LLC
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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 1386056356, we treat the final digit (6) 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 54. The final step is to find the difference between that total and the next multiple of ten (60 - 54 = 6).
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 54 is 60. The difference is the calculated check digit.
Other Providers at the Same Location
The following 11 providers are registered at the same or a nearby location.
DEARBORN, MI 48126
DEARBORN, MI 48126
DEARBORN, MI 48126
DEARBORN, MI 48126
DEARBORN, MI 48126
DEARBORN, MI 48126
DEARBORN, MI 48126
DEARBORN, MI 48126
DEARBORN, MI 48126
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1386056356, enumerated as an "organization" on May 27, 2014.
The provider is located at 17000 EXECUTIVE PLAZA DR SUITE 301 DEARBORN, MI 48126 and the phone number is (313) 408-6613.
Clinic/Center with taxonomy code 261QA1903X and a focus in Ambulatory Surgical.
The provider might be accepting Accepts: Ambetter from Buckeye Health Plan, Ambetter from. Please consult your insurance carrier or call the provider to verify.
