PEACE RIVER SURGERY CENTER
NPI 1467101907
Clinic/Center - Ambulatory Surgical in Port Charlotte, FL
NPI Status: Active since March 22, 2022
Contact Information
4130 TAMIAMI TRL UNIT 301
PORT CHARLOTTE, FL
ZIP 33952
Phone: (941) 629-5356
Fax: (941) 629-4987
- Organization
- Clinic/Center
- Ambulatory Surgical
- Accepts Insurance
- CLIA Number: 10D2255056
- CLIA Cert. Type: Ambulatory Surgery Center
- CLIA Exp. Date: 03-28-2027
About PEACE RIVER SURGERY CENTER
This page provides the complete NPI Profile along with additional information for Peace River Surgery Center, a provider established in Port Charlotte, Florida operating as a Clinic/center, focusing in ambulatory surgical . The healthcare provider is registered in the NPI registry with number 1467101907 assigned on March 2022. The practitioner's primary taxonomy code is 261QA1903X. The provider is registered as an organization and their NPI record was last updated 3 years ago. The authorized official of this NPI record is Dr. Nicolai Mejevoi Md (Medical Director)
- NPI
- 1467101907
- Provider Name
- PEACE RIVER SURGERY CENTER
- Entity Type
- Organization
- Location Address
- 4130 TAMIAMI TRL UNIT 301 PORT CHARLOTTE, FL 33952
- Location Phone
- (941) 629-5356
- Location Fax
- (941) 629-4987
- Mailing Address
- 4130 TAMIAMI TRL UNIT 301 PORT CHARLOTTE, FL 33952
- Mailing Phone
- (941) 629-5356
- Mailing Fax
- (941) 629-4987
- Is Sole Proprietor?
- No
- Is Organization Subpart?
- No
- Enumeration Date
- 03-22-2022
- Last Update Date
- 04-26-2023
- 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:
- BlueOptions Bronze (HSA) 24J01-10 (Rewards / $4 Condition Care Rx) - PPO
- BlueOptions Bronze 24J01-04 (3 PCP Visits for $0 then $55 / $70 Specialist Visits / Rewards) - PPO
- BlueOptions Bronze 24J01-06 (Rewards) - PPO
- BlueOptions Bronze 24J01-17 ($50 PCP Visits / Rewards) - PPO
- BlueOptions Bronze 24J01-18S ($50 PCP Visits / Rewards) - PPO
- BlueOptions Gold 24J01-09 ($0 Deductible / $15 PCP Visits / $75 Specialist Visits / $20 Labs / Rewards) - PPO
- BlueOptions Gold 24J01-12 ($40 PCP Visits / $75 Specialist Visits / $15 Labs / Rewards) - PPO
- BlueOptions Gold 24J01-20S ($30 PCP Visits / $60 Specialist Visits / Rewards) - PPO
- BlueOptions Platinum 24J01-05 ($0 Labs / $15 PCP Visits / $35 Specialist Visits / Rewards) - PPO
- BlueOptions Platinum 24J01-08 ($0 Deductible / $0 Labs / $15 PCP Visits / $25 Specialist Visits / Rewards) - PPO
- BlueOptions Platinum 24J01-21S ($0 Deductible / $10 PCP Visits / $20 Specialist Visits / Rewards) - PPO
- BlueOptions Silver 24J01-03 ($10 Labs / Rewards) - PPO
- BlueOptions Silver 24J01-07 ($50 PCP Visits / Rewards) - PPO
- BlueOptions Silver 24J01-19S ($40 PCP Visits / $80 Specialist Visits / Rewards) - PPO
- BlueSelect Bronze (HSA) 1735 (Rewards / $4 Condition Care Rx) - EPO
- BlueSelect Bronze 1449 (3 PCP Visits for $0 then $55 / $70 Specialist Visits / Rewards) - EPO
- BlueSelect Bronze 2139 ($50 PCP Visits / Rewards) - EPO
- BlueSelect Bronze 2139E ($50 PCP Visits / Adult Dental & Vision / Rewards) - EPO
- BlueSelect Bronze 2139V ($50 PCP Visits / Adult Vision / Rewards) - EPO
- BlueSelect Bronze 2342S ($50 PCP Visits / Rewards) - EPO
- BlueCare Bronze (HSA) 24K01-09 (Rewards / $4 Condition Care Rx) - POS
- BlueCare Bronze 24K01-03 (3 PCP Visits for $0 then $55 / $70 Specialist Visits / Rewards) - POS
- BlueCare Bronze 24K01-05 (Rewards) - POS
- BlueCare Bronze 24K01-25 ($50 PCP Visits / $75 Specialist Visits / Rewards) - POS
- BlueCare Bronze 24K01-31S ($50 PCP Visits / Rewards) - POS
- BlueCare Bronze 24K02-17 (3 PCP Visits for $0 then $55 / $70 Specialist Visits / Rewards) - POS
- BlueCare Bronze 24K02-18 (Rewards) - POS
- BlueCare Bronze 24K02-23 ($50 PCP Visits / $75 Specialist Visits / Rewards) - POS
- BlueCare Bronze 24K02-26S ($50 PCP Visits / Rewards) - POS
- BlueCare Gold 24K01-08 ($0 Deductible / $15 PCP Visits / $75 Specialist Visits / $20 Labs / Rewards) - POS
- BlueCare Gold 24K01-10 ($40 PCP Visits / $75 Specialist Visits / $15 Labs / Rewards) - POS
- BlueCare Gold 24K01-33S ($30 PCP Visits / $60 Specialist Visits / Rewards) - POS
- BlueCare Gold 24K02-20 ($0 Deductible / $15 PCP Visits / $75 Specialist Visits / $20 Labs / Rewards) - POS
- BlueCare Gold 24K02-28S ($30 PCP Visits / $60 Specialist Visits / Rewards) - POS
- BlueCare Platinum 24K01-04 ($0 Labs / $15 PCP Visits / $35 Specialist Visits / Rewards) - POS
- BlueCare Platinum 24K01-07 ($0 Deductible / $0 Labs / $15 PCP Visits / $25 Specialist Visits / Rewards) - POS
- BlueCare Platinum 24K01-34S ($0 Deductible / $10 PCP Visits / $20 Specialist Visits / Rewards) - POS
- BlueCare Platinum 24K02-15 ($0 Deductible / $0 Labs / $15 PCP Visits / $25 Specialist Visits / Rewards) - POS
- BlueCare Platinum 24K02-29S ($0 Deductible / $10 PCP Visits / $20 Specialist Visits / Rewards) - POS
- BlueCare Silver 24K01-02 ($10 Labs / Rewards) - POS
*Please verify directly with this provider to make sure your insurance plan is currently accepted.
CLIA 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
- 10D2255056
- Facility Type
- Ambulatory Surgery Center
- Certificate Effective Date
- March 29, 2025
- Certificate Expiration Date
- March 28, 2027
- Laboratory Director
- DR. DAVID J. HOTCHKISS
- Certificate Type
- Certificate of Accreditation
- Certificate Type Description
- This is a CLIA certificate is issued to Peace River Surgery Center on the basis of the laboratory's accreditation by an accreditation organization approved by CMS. This type of certificate is issued to a laboratories tha perform nonwaived (moderate and/or high complexity) testing.
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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 1467101907, we treat the final digit (7) 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 53. The final step is to find the difference between that total and the next multiple of ten (60 - 53 = 7).
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 53 is 60. The difference is the calculated check digit.
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1467101907, enumerated as an "organization" on March 22, 2022.
The provider is located at 4130 TAMIAMI TRL UNIT 301 PORT CHARLOTTE, FL 33952 and the phone number is (941) 629-5356.
Clinic/Center with taxonomy code 261QA1903X and a focus in Ambulatory Surgical.
The provider might be accepting Accepts: Florida Blue (BlueCross BlueShield FL) and Florida. Please consult your insurance carrier or call the provider to verify.
