UPSTATE SURGERY CENTER, LLC
NPI 1619998523
Clinic/Center - Ambulatory Surgical in Greenville, SC

NPI Status: Active since July 23, 2006

Contact Information

10 ENTERPRISE BLVD STE 109
GREENVILLE, SC
ZIP 29615
Phone: (864) 813-7226
Fax: (864) 556-7552

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  • Organization
  • Clinic/Center
  • Ambulatory Surgical
  • Accepts Insurance
  • CLIA Number: 42D0883226
  • CLIA Cert. Type: Ambulatory Surgery Center
  • CLIA Exp. Date: 09-16-2026

About UPSTATE SURGERY CENTER, LLC

This page provides the complete NPI Profile along with additional information for Upstate Surgery Center, Llc, a provider established in Greenville, South Carolina operating as a Clinic/center, focusing in ambulatory surgical . The healthcare provider is registered in the NPI registry with number 1619998523 assigned on July 2006. The practitioner's primary taxonomy code is 261QA1903X with license number ASF-050 (SC). The provider is registered as an organization and their NPI record was last updated March 2026. The authorized official of this NPI record is Devin Larsen (Ceo)

NPI
1619998523
Provider Name
UPSTATE SURGERY CENTER, LLC
Entity Type
Organization
Location Address
10 ENTERPRISE BLVD STE 109 GREENVILLE, SC 29615
Location Phone
(864) 813-7226
Location Fax
(864) 556-7552
Mailing Address
9709 LAKESIDE BLVD STE 350 SPRING, TX 77381
Mailing Phone
(713) 489-2198
Mailing Fax
(864) 556-7552
Is Sole Proprietor?
No
Is Organization Subpart?
No
Enumeration Date
07-23-2006
Last Update Date
03-06-2026
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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
License No.
ASF-050
License State
SC

Insurance Plans Accepted

According to publicly available information the provider might be accepting the following health plans from these health insurance companies:

  • Elite Bronze - HMO
  • Elite Bronze + Vision + Adult Dental - HMO
  • Everyday Bronze - HMO
  • Everyday Bronze + Vision + Adult Dental - HMO
  • Focused Silver - HMO
  • Standard Expanded Bronze - HMO
  • Standard Gold - HMO
  • Standard Silver - HMO
  • Standard Silver + Vision + Adult Dental - HMO
  • Clear Silver with $0 Insulin Options - HMO
  • Complete Gold - HMO
  • Complete Gold + Vision + Adult Dental - HMO
  • Complete Gold with Atrium Health - HMO
  • Complete Gold with Atrium Health + Vision + Adult Dental - HMO
  • Elite Bronze - HMO
  • Elite Bronze + Vision + Adult Dental - HMO
  • Elite Bronze with Atrium Health - HMO
  • Elite Bronze with Atrium Health + Vision + Adult Dental - HMO
  • Enhanced Asthma/COPD Care Silver with $0 Drug Options - HMO
  • Enhanced Asthma/COPD Care Silver with $0 Drug Options + Vision + Adult Dental - HMO
  • Everyday Bronze - HMO
  • Everyday Bronze + Vision + Adult Dental - HMO
  • Everyday Bronze with Atrium Health - HMO
  • Everyday Bronze with Atrium Health + Vision + Adult Dental - HMO
  • Focused Silver with Atrium Health - HMO
  • Focused Silver with Atrium Health + Vision + Adult Dental - HMO
  • Standard Expanded Bronze - HMO
  • Standard Expanded Bronze + Vision + Adult Dental - HMO
  • Standard Expanded Bronze with Atrium Health - HMO
  • Blue Direction Bronze 1 - POS
  • Blue Direction Silver 1 - POS
  • Blue Direction Silver 1 + Adult Vision - POS
  • Blue Direction Silver 2 - POS
  • Blue Direction Standard Expanded Bronze - POS
  • Blue Direction Standard Gold - POS
  • Blue Direction Standard Silver - POS
  • Blue VirtuConnect Bronze 1 - EPO
  • Blue VirtuConnect Gold 1 - EPO
  • Blue VirtuConnect Silver 1 - EPO
  • BlueEssentials Bronze 4 - EPO
  • BlueEssentials Bronze 6 - EPO
  • BlueEssentials Gold 1 - EPO
  • BlueEssentials Gold 5 - EPO
  • BlueEssentials Silver 14 - EPO
  • BlueEssentials Silver 14 + Adult Vision - EPO
  • BlueEssentials Silver 40 - EPO
  • BlueEssentials Standard Expanded Bronze - EPO
  • BlueEssentials Standard Gold - EPO
  • BlueEssentials Standard Silver - EPO
  • Molina Gold Core 1640 - HMO
  • Molina Gold Core 1640 Plus with Adult Dental and Vision - HMO
  • Molina Gold Core 1640 Plus with Adult Vision - HMO
  • Molina Gold Standard - HMO
  • Molina Gold Value - HMO
  • Molina Gold Value Plus with Adult Dental and Vision - HMO
  • Molina Gold Value Plus with Adult Vision - HMO
  • Molina Silver Core - HMO
  • Molina Silver Core Plus with Adult Dental and Vision - HMO
  • Molina Silver Core Plus with Adult Vision - HMO
  • Molina Silver Saver - HMO
  • Molina Silver Standard - HMO
  • UHC Bronze Copay Focus $0 Indiv Med Ded - HMO
  • UHC Bronze Copay Focus+ $0 Indiv Med Ded (Dental + Vision) - HMO
  • UHC Bronze Essential - HMO
  • UHC Bronze Essential- - HMO
  • UHC Bronze Standard - HMO
  • UHC Bronze Standard Plus Chiro - HMO
  • UHC Gold Advantage - HMO
  • UHC Gold Advantage+ (Dental + Vision) - HMO
  • UHC Gold Copay Focus $0 Indiv Med Ded - HMO
  • UHC Gold Standard - HMO
  • UHC Gold Standard Plus Chiro - HMO
  • UHC Silver Advantage - HMO
  • UHC Silver Advantage+ (Dental + Vision) - HMO
  • UHC Silver Copay Focus $0 Indiv Med Ded - HMO
  • UHC Silver Standard - HMO
  • UHC Silver Standard- - HMO
  • UHC Silver Standard Plus Chiro - 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

DEVIN LARSEN

Authorized Official Title
CEO
Authorized Official Phone
(631) 445-0593

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.

Complex removal of cataract with insertion of prosthetic lens

This procedure involves removing a cloudy lens (cataract) from your eye and replacing it with a clear, artificial lens. It helps restore vision that has been affected by the cataract. The operation is usually done under local anesthesia.

This service was performed 96 times for 78 patients

Creation of shunt to improve eye fluid flow using tissue graft

This procedure involves creating a new pathway for fluid to flow out of your eye using a tissue graft. It helps to lower eye pressure and prevent damage to your optic nerve, improving eye health and vision.

This service was performed 19 times for 17 patients

Destruction of lens tissue using laser

Destruction of lens tissue using a laser is a medical procedure aimed at treating eye conditions like cataracts. A laser is employed to break down the affected lens tissue, which is then removed. This allows the insertion of an artificial lens to improve vision.

This service was performed 26 times for 25 patients

Extracapsular removal of cataract with insertion of artificial lens and insertion of drainage device in front chamber of eye

This is a two-part eye procedure. First, a cloudy lens (cataract) is removed from its outer layer and replaced with an artificial lens to improve vision. Second, a drainage device is inserted into the front part of the eye to manage fluid levels, preventing pressure build-up.

This service was performed 22 times for 15 patients

Processing, preserving and transporting corneal tissue

Processing, preserving, and transporting corneal tissue involve careful steps to ensure its viability for transplantation. The tissue is first cleaned, then preserved in a special solution. It's packed in a temperature-controlled container for safe transport to its destination.

This service was performed 13 times for 13 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 1,322 times for 806 patients

Removal of excessive skin and fat of upper eyelid

This procedure, also known as upper eyelid surgery, is performed to remove excess skin and fat from the upper eyelid. It can help improve vision if heavy eyelids hinder it, and can also enhance the appearance of the eyes. It's a common, safe procedure.

This service was performed 55 times for 28 patients

Repair of tendon of upper eyelid

Repair of the tendon of the upper eyelid is a surgical procedure aimed at fixing a droopy eyelid. This condition can affect your vision and appearance. The procedure involves tightening the tendon to lift the eyelid to its normal position, improving both function and aesthetics.

This service was performed 91 times for 50 patients

Repair of wound of eyelids, nose, ears, or lips by transferring skin, 10.0 sq cm or less

This procedure involves repairing a wound on the eyelids, nose, ears, or lips by moving a small piece of skin (10.0 sq cm or less) from one area to another. The goal is to heal the wound and restore the function and appearance of the affected area.

This service was performed 11 times for 11 patients

Transplantation of outer layer of corneal tissue

The transplantation of the outer layer of corneal tissue is a procedure to replace damaged or diseased corneal tissue with healthy tissue from a donor. This can improve vision and alleviate pain or discomfort.

This service was performed 13 times for 13 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
42D0883226
Facility Type
Ambulatory Surgery Center
Certificate Effective Date
September 17, 2024
Certificate Expiration Date
September 16, 2026
Laboratory Director
LISA BROWN
Certificate Type
Certificate of Waiver
Certificate Type Description
This CLIA certificate is issued to Upstate 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 1619998523, we treat the final digit (3) 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 77. The final step is to find the difference between that total and the next multiple of ten (80 - 77 = 3).

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
6
Unchanged
Pos 3
1
Doubled → 2
Pos 4
9
Unchanged
Pos 5
9
Doubled → 18 → 1 + 8
Pos 6
9
Unchanged
Pos 7
8
Doubled → 16 → 1 + 6
Pos 8
5
Unchanged
Pos 9
2
Doubled → 4
Check
3
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 1 → 2 9 → 18 → 9 8 → 16 → 7 2 → 4

Step 2: Add all digits plus the NPI constant

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

2 + 6 + 2 + 9 + 1 + 8 + 9 + 1 + 6 + 5 + 4 + 24 = 77

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

The next multiple of ten after 77 is 80. The difference is the calculated check digit.

80 - 77 = 3
This NPI is valid
The calculated check digit is 3, which matches the last digit of 1619998523.

Other Providers at the Same Location


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

Nurse Practitioner (Family)
10 ENTERPRISE BLVD STE 109
GREENVILLE, SC 29615
Anesthesiology
10 ENTERPRISE BLVD STE 109
GREENVILLE, SC 29615

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1619998523, enumerated as an "organization" on July 23, 2006.

The provider is located at 10 ENTERPRISE BLVD STE 109 GREENVILLE, SC 29615 and the phone number is (864) 813-7226.

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

The provider might be accepting Accepts: Ambetter from Absolute Total Care, Ambetter of. Please consult your insurance carrier or call the provider to verify.