ST. AUGUSTINE AMBULATORY SURGERY CENTER, LLC
NPI 1598643140
Clinic/Center - Ambulatory Surgical in St Augustine, FL

NPI Status: Active since August 22, 2025

Contact Information

45 GROOVER LOOP
ST AUGUSTINE, FL
ZIP 32086
Phone: (904) 648-8660

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  • Organization
  • Clinic/Center
  • Ambulatory Surgical
  • CLIA Number: 10D2335885
  • CLIA Cert. Type: Ambulatory Surgery Center
  • CLIA Exp. Date: 12-18-2027

About ST. AUGUSTINE AMBULATORY SURGERY CENTER, LLC

This page provides the complete NPI Profile along with additional information for St. Augustine Ambulatory Surgery Center, Llc, a provider established in St Augustine, Florida operating as a Clinic/center, focusing in ambulatory surgical . The healthcare provider is registered in the NPI registry with number 1598643140 assigned on August 2025. 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 Robert Haen (Executive Director)

NPI
1598643140
Provider Name
ST. AUGUSTINE AMBULATORY SURGERY CENTER, LLC
Entity Type
Organization
Location Address
45 GROOVER LOOP ST AUGUSTINE, FL 32086
Location Phone
(904) 648-8660
Mailing Address
45 GROOVER LOOP ST. AUGUSTINE, FL 32086
Mailing Phone
(904) 648-8660
Is Sole Proprietor?
No
Is Organization Subpart?
No
Enumeration Date
08-22-2025
Last Update Date
08-22-2025
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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

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

ROBERT HAEN

Authorized Official Title
EXECUTIVE DIRECTOR
Authorized Official Phone
(904) 648-8660

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
10D2335885
Facility Type
Ambulatory Surgery Center
Certificate Effective Date
December 19, 2025
Certificate Expiration Date
December 18, 2027
Laboratory Director
KURTIS HORT
Certificate Type
Certificate of Waiver
Certificate Type Description
This CLIA certificate is issued to St. Augustine Ambulatory Surgery 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.

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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 1598643140, 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 70. The final step is to find the difference between that total and the next multiple of ten (70 - 70 = 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
9
Doubled → 18 → 1 + 8
Pos 4
8
Unchanged
Pos 5
6
Doubled → 12 → 1 + 2
Pos 6
4
Unchanged
Pos 7
3
Doubled → 6
Pos 8
1
Unchanged
Pos 9
4
Doubled → 8
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 9 → 18 → 9 6 → 12 → 3 3 → 6 4 → 8

Step 2: Add all digits plus the NPI constant

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

2 + 5 + 1 + 8 + 8 + 1 + 2 + 4 + 6 + 1 + 8 + 24 = 70

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

The next multiple of ten after 70 is 70. The difference is the calculated check digit.

70 - 70 = 0
This NPI is valid
The calculated check digit is 0, which matches the last digit of 1598643140.

Other Providers at the Same Location


The following 3 providers are registered at the same or a nearby location.

Anesthesiology
45 GROOVER LOOP
ST AUGUSTINE, FL 32086
Physician Assistant
45 GROOVER LOOP
ST AUGUSTINE, FL 32086
Physician Assistant
45 GROOVER LOOP
SAINT AUGUSTINE, FL 32086

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1598643140, enumerated as an "organization" on August 22, 2025.

The provider is located at 45 GROOVER LOOP ST AUGUSTINE, FL 32086 and the phone number is (904) 648-8660.

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