COUNTRYSIDE SURGERY CENTER, LTD
NPI 1518920040
Clinic/Center - Ambulatory Surgical in Clearwater, FL

Q: What is Countryside Surgery Center, Ltd's NPI number?

The NPI number for Countryside Surgery Center, Ltd is 1518920040. It was assigned to this organization in the NPPES registry on April 7, 2006.

Q: What is Countryside Surgery Center, Ltd's specialty?

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

Active since April 07, 2006CLIA 10D0721298 · Waiver

3291 N MCMULLEN BOOTH RD, CLEARWATER, FL 33761(727) 725-5800(727) 797-4002 Get Directions Write a Review

NPPES record last updated: September 8, 2026. Verified against the NPPES registry weekly; last sync: November 08, 2026.

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About Countryside Surgery Center, Ltd NPPES

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

COUNTRYSIDE SURGERY CENTER, LTD (NPI 1518920040) is a healthcare organization registered as an ambulatory surgical in Clearwater, Florida and active in the NPI registry since April 2006. The organization holds a CLIA Waiver certificate valid through August 31, 2028 and lists David Mcknight, Vp/cfo, as its authorized official.

NPPES Registry Identity

NPI1518920040

Entity TypeOrganization

Primary Taxonomy261QA1903X

Legal Business NameCOUNTRYSIDE SURGERY CENTER, LTD

Location Address3291 N MCMULLEN BOOTH RDClearwater, FL 33761-2010

Mailing Address3291 N Mcmullen Booth RdClearwater, FL 33761-2010 · (727) 725-5800 · Fax (727) 797-4002

Phone(727) 725-5800

Fax(727) 797-4002

Organization SubpartNo

Authorized OfficialDavid McknightVp/cfo · (972) 789-2816

Enumeration DateApril 7, 2006

Last NPPES UpdateSeptember 8, 2026

NPPES CertifiedSeptember 8, 2026

✔ NPI 1518920040 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 FL · 986

3291 N MCMULLEN BOOTH RD, Clearwater, FL 33761

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Other Identifiers 1

Medicaid079131800FL

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Superior HealthPlan, Ambetter Health, Ambetter of Alabama and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Countryside Surgery Center, Ltd is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

Medicare enrollment records show 10 clinicians reassign Medicare billing to Countryside Surgery Center, Ltd, which bills Medicare for the services they deliver. Of these, 5 practice within 10 miles. They are listed nearest first.

Clinicians by Medicare Specialty 3

Gastroenterology5

Pathology4

Internal Medicine1

Clinicians, nearest first (10)

Sanjiv Amin, DO

Gastroenterology

NPI 1467450080

34041 US HIGHWAY 19 N SUITE A
Palm Harbor, FL 34684

(727) 786-0017

✔ PECOS✔ Accepts Medicare3.3 mi

Kevin Humphreys, MD

Internal Medicine

NPI 1578854733

34041 US 19 N STE A
Palm Harbor, FL 34684

(727) 786-0017

✔ PECOS✔ Accepts Medicare3.3 mi

Jawahar Taunk, MD

Gastroenterology

NPI 1528066271

34041 US HIGHWAY 19 N SUITE A
Palm Harbor, FL 34684

(727) 786-0017

✔ PECOS✔ Accepts Medicare3.3 mi

Mirela Onea, M.D

Gastroenterology

NPI 1144467531

34041 US HIGHWAY 19 N STE A
Palm Harbor, FL 34684

(727) 786-0017

✔ PECOS✔ Accepts Medicare3.3 mi

Jeffrey Smith, M.D.

Pathology

NPI 1689735383

1395 S PINELLAS AVE HELEN ELLIS MEMORIAL HOSPITAL
Tarpon Springs, FL 34689

(727) 942-5113

✔ PECOS✔ Accepts Medicare7.0 mi

John Williams, DO

Pathology

NPI 1598744393

2821 SEABREEZE DR S
Gulfport, FL 33707

(727) 667-2074

✔ PECOS✔ Accepts Medicare21 mi

Archi Patel, M.D.

Pathology

NPI 1710368501

18311 HIGHWOODS PRESERVE PKWY UNIT 6413
Tampa, FL 33647

(908) 316-2324

✔ PECOS✔ Accepts Medicare22 mi

Tiyyagura Reddy

Gastroenterology

NPI 1205848595

7614 JACQUE RD STE B
Hudson, FL 34667

(727) 863-2105

✔ PECOS22 mi

James Allen, MD

Pathology

NPI 1073592812

120 E NORTH BLVD SUITE 102
Leesburg, FL 34748

(352) 460-0292

✔ PECOS✔ Accepts Medicare74 mi

Ashok Shiani, M.D.

Gastroenterology

NPI 1629462700

2421 SILVER STREAM LN
Wilmington, NC 28401

(910) 341-3343

✔ PECOS✔ Accepts Medicare510 mi

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

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 10D0721298

Countryside Surgery Center · Clearwater, FL

Active · expires Aug 31, 2028

CLIA Number10D0721298

Laboratory TypeAmbulatory Surgery Center

Certificate Effective DateSeptember 1, 2026

Certificate Expiration DateAugust 31, 2028

Laboratory DirectorChristopher Palermo

Laboratory Phone(727) 725-5800

Laboratory LocationCountryside Surgery Center3291 N Mcmullen Booth Rd, Clearwater, FL 33761

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 23

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, bupivacaine liposome, 1 mg C9290

Bupivacaine liposome is a local anesthetic used to numb a specific area of the body and reduce pain or discomfort associated with surgical procedures. The 1 mg dosage is injected by a healthcare professional at the required site.

6,118 services23 patients

Removal of cataract with insertion of prosthetic lens 66984

This 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.

154 services97 patients

Removal of polyps or growths of large bowel using an endoscope with mechanical snare 45385

This procedure involves using a thin, flexible tube called an endoscope to examine the large bowel. If any abnormal growths or polyps are found, a tool called a mechanical snare is used to remove them. This is a common method to prevent potential health issues.

63 services63 patients

Removal of recurring cataract in lens capsule using a laser 66821

This 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.

55 services37 patients

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.

43 services26 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.

39 services35 patients

Removal of nasal air passage under lining tissue 30140

This procedure, often done to improve breathing or address sinus issues, involves the removal of tissue from the lining of the nasal air passage. It's performed under anesthesia and recovery time varies based on individual health status.

37 services19 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.

32 services23 patients

Incision of eardrum with placement of eardrum tube under general anesthesia 69436

This procedure involves making a small cut in the eardrum to drain fluid and alleviate pressure. A tiny tube is then inserted to keep the hole open and prevent further fluid buildup. General anesthesia is used to ensure patient comfort.

31 services22 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.

28 services27 patients

Removal of nasal sinus tissue using an endoscope 31267

This procedure, known as endoscopic sinus surgery, involves using a thin, flexible tube with a light and camera to view and remove problematic nasal sinus tissue. It helps to alleviate sinus issues and improve breathing.

28 services18 patients

Biopsy of esophagus, stomach, and/or upper small bowel using a flexible endoscope 43239

This procedure involves using a thin, flexible tube with a light and camera, known as an endoscope, to examine the esophagus, stomach, and upper part of the small intestine. Small tissue samples are taken for further examination to help diagnose various conditions.

28 services28 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.

27 services27 patients

Biopsy of large bowel using a flexible endoscope 45380

A biopsy of the large bowel using a flexible endoscope is a procedure where a thin, flexible tube with a camera is inserted through the rectum to examine the bowel. If abnormal tissue is found, a small sample is taken for further examination. This helps in diagnosing conditions like inflammation, polyps, or cancer.

21 services21 patients

Cystourethroscopy, with insertion of transprostatic implant; 4 or more implants C9740

Cystourethroscopy with insertion of transprostatic implant is a procedure where tiny implants are placed in the prostate area via a thin tube inserted through the urinary passage. This helps to manage urinary flow issues. Four or more implants may be used.

20 services20 patients

Repair of detached retina with drainage and removal of eye fluid between lens and retina 67108

This procedure addresses a detached retina, a serious eye condition. It involves draining fluid from between the lens and retina, allowing the retina to reattach. Then, the eye fluid is removed to prevent future detachments. It's a crucial step for vision restoration.

16 services12 patients

Incision or partial removal of foot bone (other than big toe) to straighten toe 28308

This procedure involves making a small incision to partially remove a bone in the foot, excluding the big toe. The aim is to straighten a misaligned toe. It helps in relieving pain, improving foot function, and enhancing shoe comfort.

15 services12 patients

Removal of knee cartilage using an endoscope 29881

This procedure, known as arthroscopic knee surgery, involves using a small camera (endoscope) to view the inside of your knee. Small instruments are used to remove damaged cartilage. This can help alleviate pain and improve knee function.

15 services15 patients

Shock wave crushing of kidney stones 50590

Shock wave crushing of kidney stones, also known as Extracorporeal Shock Wave Lithotripsy (ESWL), is a non-invasive treatment. It involves the use of sound waves to break down kidney stones into small pieces that can easily pass through your urinary tract.

15 services15 patients

Removal of both knee cartilages using an endoscope 29880

This procedure, also known as bilateral knee arthroscopy, involves using a small camera (endoscope) to view and remove damaged cartilage from both knees. It's a minimally invasive surgery aimed at relieving pain and improving mobility.

14 services14 patients

Anchoring of biceps tendon 23430

Anchoring of the biceps tendon is a surgical procedure aimed at restoring stability to your arm. The surgeon secures your biceps tendon to the bone using special anchors, which helps to reduce pain and improve arm function.

13 services13 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.

12 services12 patients

Reshaping of nasal cartilage 30520

Reshaping of nasal cartilage, also known as rhinoplasty, is a surgical procedure to modify the structure of the nose for aesthetic or functional purposes. It involves adjusting the cartilage and bone in the nose to achieve the desired shape or to improve breathing.

12 services12 patients

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 Countryside Surgery Center, Ltd's NPI number?

The NPI number for Countryside Surgery Center, Ltd is 1518920040. It was assigned to this organization in the NPPES registry on April 7, 2006.

Where is Countryside Surgery Center, Ltd located?

Countryside Surgery Center, Ltd is located at 3291 N Mcmullen Booth Rd, Clearwater, FL 33761. The listed phone number is (727) 725-5800.

What is Countryside Surgery Center, Ltd's specialty?

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

Is Countryside Surgery Center, Ltd enrolled in Medicare?

Yes. Countryside Surgery Center, Ltd is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Countryside Surgery Center, Ltd?

According to the CMS Revalidation Reassignment List (October 2026 release), 10 clinicians in 3 Medicare specialties reassign their Medicare billing to Countryside Surgery Center, Ltd. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. The largest specialties are Gastroenterology (5), Pathology (4) and Internal Medicine (1). Of these, 5 practice within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Does Countryside Surgery Center, Ltd hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 10D0721298) is associated with this NPI, valid through August 31, 2028. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

What insurance does Countryside Surgery Center, Ltd accept?

Health plans from Ambetter Health, Ambetter from Superior HealthPlan, Ambetter of Alabama, AvMed and Florida Blue (BlueCross BlueShield FL) and 3 other insurers list Countryside Surgery Center, Ltd 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 Countryside Surgery Center, Ltd was last updated on September 8, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 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 Countryside Surgery Center, Ltd NPPES

NPPES Registry Identity

Specialties & Licenses

Other Identifiers 1

Accepted Insurance

Medicare Participation & PECOS CMS

Medicare Enrollment Status

Clinicians Billing Medicare Through This Organization

Clinicians by Medicare Specialty 3

Clinicians, nearest first (10)

CLIA Laboratory Certificates CMS CLIA

Certificate of Waiver · 10D0721298

Areas of Expertise CMS Part B claims 23

Frequently Asked Questions NPPES & CMS

What is Countryside Surgery Center, Ltd's NPI number?

Where is Countryside Surgery Center, Ltd located?

What is Countryside Surgery Center, Ltd's specialty?

Is Countryside Surgery Center, Ltd enrolled in Medicare?

How many clinicians bill Medicare through Countryside Surgery Center, Ltd?

Does Countryside Surgery Center, Ltd hold a CLIA laboratory certificate?

What insurance does Countryside Surgery Center, Ltd accept?

When was this NPI record last updated?

Certificate of Waiver 10D0721298