ORANGE CITY SURGICAL LLC
NPI 1558580910
Clinic/Center - Ambulatory Surgical in Orange City, FL

NPI Status: Active since April 24, 2007

Contact Information

1053 MEDICAL CENTER DRIVE
ORANGE CITY, FL
ZIP 32763
Phone: (352) 000-0000

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  • Organization
  • Clinic/Center
  • Ambulatory Surgical
  • Accepts Insurance
  • CLIA Number: 10D1077366
  • CLIA Cert. Type: Ambulatory Surgery Center
  • CLIA Exp. Date: 12-06-2025

About ORANGE CITY SURGICAL LLC

This page provides the complete NPI Profile along with additional information for Orange City Surgical Llc, a provider established in Orange City, Florida operating as a Clinic/center, focusing in ambulatory surgical . The healthcare provider is registered in the NPI registry with number 1558580910 assigned on April 2007. 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 provider's . The authorized official of this NPI record is Khelsea Bauer (Ceo/secretary)

NPI
1558580910
Provider Legal Name
ORANGE CITY SURGICAL LLC
Other Organization Name
Other Name Type
(6)
Entity Type
Organization
Location Address
1053 MEDICAL CENTER DRIVE ORANGE CITY, FL 32763
Location Phone
(352) 000-0000
Mailing Address
1053 MEDICAL CENTER DR STE 201 ORANGE CITY, FL 32763
Mailing Phone
(386) 878-8080
Is Sole Proprietor?
No
Is Organization Subpart?
No
Enumeration Date
04-24-2007
Last Update Date
09-09-2025
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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
  • Gym Access IND Bronze HMO 1340 - HMO
  • Gym Access IND Bronze HMO OA 1211 - HMO
  • Gym Access IND Bronze HMO OA Standard 2450 - HMO
  • Gym Access IND Bronze POS 1042 - POS
  • Gym Access IND Bronze POS BC 3841 - POS
  • Gym Access IND Bronze POS OA 1211 - POS
  • Gym Access IND Bronze POS OA Standard 2450 - POS
  • Gym Access IND Bronze Standardized HMO - HMO
  • Gym Access IND Gold HMO 4500 - HMO
  • Gym Access IND Gold HMO BC 5651 - HMO
  • Gym Access IND Gold HMO H.S.A 9010 - HMO
  • Gym Access IND Gold HMO OA Standard 3450 - HMO
  • Gym Access IND Gold POS 55001 - POS
  • Gym Access IND Gold POS BC 5651 - POS
  • Gym Access IND Gold POS OA Standard 3450 - POS
  • Gym Access IND Silver HMO BC 0941 - HMO
  • Gym Access IND Silver HMO BC 7741 - HMO
  • Gym Access IND Silver HMO OA 1009 - HMO
  • Gym Access IND Silver HMO OA Standard 1440 - HMO
  • Gym Access IND Silver POS BC 0941 - POS
  • Bronze 1826 ($0 Medical Deductible, $0 Primary Care Copay- Visits 1 & 2, Specialist & Urgent Care Copay, Open Access) - HMO
  • Bronze 1826 + Adult Dental + Adult Vision ($0 Medical Deductible, $0 Primary Care Copay- Visits 1 & 2, Specialist & Urgent Care Copay, Open Access) - HMO
  • Bronze Savings 1820 (Primary Care Copay Visits 1-5, Open Access) - HMO
  • Bronze Savings 1820 + Adult Dental + Adult Vision (Primary Care Copay Visits 1-5, Open Access) - HMO
  • Bronze Standard 1828 - HMO
  • Bronze Value 1814 (High Value Network Savings, Open Access) - HMO
  • Bronze Value 1814 + Adult Dental + Adult Vision (High Value Network Savings, Open Access) - HMO
  • Catastrophic 1746 (Primary Care Copay Visits 1-3, Open Access) - HMO
  • Gold 1742 (Emergency Room & Inpatient Hospitalization Copay, $0 Outpatient Labs, $0 MRI, Open Access) - HMO
  • Gold 1742 + Adult Dental + Adult Vision (Emergency Room & Inpatient Hospitalization Copay, $0 Outpatient Labs, $0 MRI, Open Access) - HMO
  • Gold Savings 1825 ($25 Primary Care Copay, $50 Specialist Copay, Open Access) - HMO
  • Gold Savings 1825 + Adult Dental + Adult Vision ($25 Primary Care Copay, $50 Specialist Copay, Open Access) - HMO
  • Gold Standard 1833 - HMO
  • Gold Value 1819 ($2,200 Tier 1 Medical Deductible, High Value Network Savings, Open Access) - HMO
  • Gold Value 1819 + Adult Dental + Adult Vision ($2,200 Tier 1 Medical Deductible, High Value Network Savings, Open Access) - HMO
  • Gold Value 1819 + Enhanced Diabetes Benefits ($2,200 Tier 1 Medical Deductible, High Value Network Savings, Open Access) - HMO
  • Silver 1664 (Primary Care & Specialist Copays, Open Access) - HMO
  • Silver 1664 + Adult Dental + Adult Vision (Primary Care & Specialist Copays, Open Access) - HMO
  • Silver Savings 1821 (Primary Care Copay, Open Access) - HMO
  • Silver Savings 1821 + Adult Dental + Adult Vision (Primary Care Copay, Open Access) - HMO
  • Bronze Classic 4700 - HMO
  • Bronze Classic 4700 | with AdventHealth - HMO
  • Bronze Classic Standard - HMO
  • Bronze Classic Standard | with AdventHealth - HMO
  • Bronze Elite + PCP Saver Plus - HMO
  • Bronze Elite + PCP Saver Plus | with AdventHealth - HMO
  • Bronze Simple Breathe Easy with Enhanced COPD Benefits - HMO
  • Bronze Simple Chronic Care CKM - HMO
  • Bronze Simple Diabetes - HMO
  • Gold Classic Standard - HMO
  • Gold Classic Standard | with AdventHealth - HMO
  • Gold Elite Saver Plus | with AdventHealth - HMO
  • Gold Simple - HMO
  • Gold Simple | with AdventHealth - HMO
  • Silver Classic Standard - HMO
  • Silver Classic Standard | with AdventHealth - HMO
  • Silver Elite - HMO
  • Silver Elite | with AdventHealth - HMO
  • Silver Simple Breathe Easy with Enhanced COPD Benefits - HMO
  • Silver Simple Chronic Care CKM - HMO

*Please verify directly with this provider to make sure your insurance plan is currently accepted.

Authorized Official

The authorized official is the designated individual with the legal authority to make changes to the provider’s official NPI record. For organizations, the authorized official must be a general partner, chairman of the board, CEO, CFO or a direct owner holding at least a 5 percent stake in the medical organization.

Authorized Official Name

KHELSEA BAUER

Authorized Official Title
CEO/SECRETARY
Authorized Official Phone
(240) 367-2110

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.

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

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.

This service was performed 25 times for 25 patients

Biopsy of large bowel using a flexible endoscope

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.

This service was performed 27 times for 27 patients

Injection of anesthetic and/or steroid drug into sacral spine nerve root using imaging guidance, single level

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 193 times for 125 patients

Injection of lower or sacral spine facet joint using imaging guidance, single level

This procedure involves injecting medication into the facet joint in your lower back or sacral spine. It's done under imaging guidance to ensure accuracy. The aim is to alleviate pain and inflammation. It's a safe, often effective method for managing spinal discomfort.

This service was performed 48 times for 19 patients

Injection of substance into lower spine canal using imaging guidance

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.

This service was performed 39 times for 32 patients

Injection procedure for sacroiliac joint; provision of anesthetic, steroid and/or other therapeutic agent, with or without arthrography

This 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 patients

Phenylephrine 10.16 mg/ml and ketorolac 2.88 mg/ml ophthalmic irrigation solution, 1 ml

This solution is used during eye surgery to maintain pupil dilation and reduce inflammation. Phenylephrine widens the pupil, while Ketorolac helps to prevent pain and swelling. It's applied directly to the eye by your healthcare provider during the procedure.

This service was performed 145 times for 33 patients

Release and/or relocation of hand nerve

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.

This service was performed 22 times for 20 patients

Removal of both knee cartilages using an endoscope

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.

This service was performed 18 times for 18 patients

Removal of cataract with insertion of prosthetic lens

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.

This service was performed 75 times for 68 patients

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

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.

This service was performed 22 times for 22 patients

Replacement of knee joint, both sides of knee

A bilateral knee joint replacement is a procedure where the damaged parts of both your knee joints are replaced with artificial parts. It aims to relieve pain and improve mobility. The process involves a surgical operation under anesthesia.

This service was performed 14 times for 14 patients

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
10D1077366
Facility Type
Ambulatory Surgery Center
Certificate Effective Date
December 07, 2023
Certificate Expiration Date
December 06, 2025
Laboratory Director
CHRISTOPHER NILES
Certificate Type
Certificate of Waiver
Certificate Type Description
This CLIA certificate is issued to Orange City Surgical 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.

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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 1558580910, we treat the final digit (0) 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 60. The final step is to find the difference between that total and the next multiple of ten (60 - 60 = 0).

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.

Pos 1
1
Doubled → 2
Pos 2
5
Unchanged
Pos 3
5
Doubled → 10 → 1 + 0
Pos 4
8
Unchanged
Pos 5
5
Doubled → 10 → 1 + 0
Pos 6
8
Unchanged
Pos 7
0
Doubled → 0
Pos 8
9
Unchanged
Pos 9
1
Doubled → 2
Check
0
Target digit
Regular digit Doubled digit Check digit

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.

1 → 2 5 → 10 → 1 5 → 10 → 1 0 → 0 1 → 2

Step 2: Add all digits plus the NPI constant

Add the transformed values, the unchanged digits, and the constant 24.

2 + 5 + 1 + 0 + 8 + 1 + 0 + 8 + 0 + 9 + 2 + 24 = 60

Step 3: Find the amount needed to reach the next multiple of 10

The next multiple of ten after 60 is 60. The difference is the calculated check digit.

60 - 60 = 0
This NPI is valid
The calculated check digit is 0, which matches the last digit of 1558580910.

Other Providers at the Same Location


The following 2 providers are registered at the same or a nearby location.

Nurse Anesthetist, Certified Registered
1053 MEDICAL CENTER DRIVE
ORANGE CITY, FL 32763
Orthopaedic Surgery
1053 MEDICAL CENTER DRIVE, SUITE 101
ORANGE CITY, FL 32763

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1558580910, enumerated as an "organization" on April 24, 2007.

The provider is located at 1053 MEDICAL CENTER DRIVE ORANGE CITY, FL 32763 and the phone number is (352) 000-0000.

Clinic/Center with taxonomy code 261QA1903X and a focus in Ambulatory Surgical.

The provider might be accepting Accepts: Florida Blue (BlueCross BlueShield FL), Florida. Please consult your insurance carrier or call the provider to verify.