CRATER LAKE SURGERY CENTER LLC
NPI 1679939318
Clinic/Center - Ambulatory Surgical in Medford, OR

Q: What is Crater Lake Surgery Center LLC's NPI number?

The NPI number for Crater Lake Surgery Center LLC is 1679939318. It was assigned to this organization in the NPPES registry on January 11, 2016.

Q: What is Crater Lake Surgery Center LLC's specialty?

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

Active since January 11, 2016CLIA 38D2149296 · Waiver

833 BENNETT AVE, MEDFORD, OR 97504(541) 779-5228 Get Directions Write a Review

NPPES record last updated: June 18, 2018. Verified against the NPPES registry weekly; last sync: November 01, 2026.

Record update history: Jun 18, 2018, Jan 11, 2016 (2 updates tracked since 2016).

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About Crater Lake Surgery Center Llc NPPES

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

CRATER LAKE SURGERY CENTER LLC (NPI 1679939318) is a healthcare organization registered as an ambulatory surgical in Medford, Oregon and active in the NPI registry since January 2016. The organization holds a CLIA Waiver certificate valid through May 29, 2028, maintains a secondary practice location in Medford, and lists Joseph Savino, Member, as its authorized official.

NPPES Registry Identity

NPI1679939318

Entity TypeOrganization

Primary Taxonomy261QA1903X

Legal Business NameCRATER LAKE SURGERY CENTER LLC

Location Address833 BENNETT AVEMedford, OR 97504-6715

Mailing Address825 Bennett AveMedford, OR 97504-6715

Phone(541) 779-5228

Organization SubpartNo

Authorized OfficialJoseph SavinoMember · (541) 779-5228

Enumeration DateJanuary 11, 2016

Last NPPES UpdateJune 18, 20182 updates tracked since enumeration

✔ NPI 1679939318 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyClinic/Center · Ambulatory SurgicalAmbulatory Health Care Facilities

Taxonomy Code261QA1903X

833 BENNETT AVE, Medford, OR 97504

Open in Google Maps ↗

Secondary Practice Location 1

Location 1835 Bennett AveMedford, OR 97504-6715 · Phone (541) 779-5228

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include BridgeSpan Health Company, Moda Health Plan, Inc., Providence Health Plan 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)

Crater Lake Surgery Center Llc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

Medicare enrollment records show 1 clinician reassigns Medicare billing to Crater Lake Surgery Center LLC, which bills Medicare for the services this clinician delivers.

Clinician (1)

Karl Freydl, DO

Physical Medicine and Rehabilitation

NPI 1720183353

25500 MEADOWBROOK RD STE 250
Novi, MI 48375

(248) 784-3667

✔ PECOS✔ Accepts Medicare1,997 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 38D2149296

Crater Lake Surgery Center · Medford, OR

Active · expires May 29, 2028

CLIA Number38D2149296

Laboratory TypeAmbulatory Surgery Center

Certificate Effective DateMay 30, 2026

Certificate Expiration DateMay 29, 2028

Laboratory DirectorDr. Joseph M. Savino MD

Laboratory Phone(541) 779-5528

Laboratory LocationCrater Lake Surgery Center833 Bennett Ave, Medford, OR 97504

CLIA data matches this NPI record on: Address Name

This certificate is issued to a laboratory to perform only waived tests.

Areas of Expertise CMS Part B claims 12

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 of lower or sacral spine facet joint using imaging guidance, single level 64493

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.

395 services124 patients

Destruction of lower or sacral spinal facet joint nerves using imaging guidance, single facet joint 64635

This procedure involves using imaging guidance to accurately target and destroy nerves in the lower or sacral spinal facet joint. It's done to relieve chronic back pain. The process is safe and usually effective.

251 services121 patients

Injection procedure for sacroiliac joint; provision of anesthetic, steroid and/or other therapeutic agent, with or without arthrography G0260

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.

247 services107 patients

Injection of anesthetic and/or steroid drug into sacral spine nerve root using imaging guidance, single level 64483

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.

237 services143 patients

Injection of substance into lower spine canal using imaging guidance 62323

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.

141 services111 patients

Injection of upper or middle spine facet joint using imaging guidance, single level 64490

This procedure involves injecting medication into a joint in your upper or middle spine. It's performed under imaging guidance for precision. The aim is to reduce inflammation and pain. It's a single-level process, meaning one joint is treated at a time.

93 services34 patients

Injection of substance into middle or upper spine canal using imaging guidance 62321

This procedure involves injecting a substance into your middle or upper spine canal. It's performed under imaging guidance to ensure accuracy. The substance can help diagnose or treat various conditions, providing relief from symptoms.

74 services52 patients

Insertion of spinal neurostimulator electrode array through skin 63650

This procedure involves placing a small device, called a neurostimulator electrode array, under your skin near your spine. It delivers mild electrical signals to your spinal cord, helping to manage chronic pain.

70 services20 patients

Destruction of upper or middle spinal facet joint nerves using imaging guidance, single facet joint 64633

This procedure involves the use of imaging technology to guide a needle to the nerves of a single facet joint in the upper or middle spine. The nerves are then treated to alleviate pain and improve mobility.

59 services34 patients

Destruction of nerve branches of knee using imaging guidance 64624

This procedure involves the use of imaging technology to accurately locate and destroy specific nerve branches in the knee. This can help reduce chronic knee pain. The procedure is minimally invasive and usually performed under local anesthesia.

26 services22 patients

Heat destruction of intraosseous basivertebral nerve in bones of spine in lower back, first two bones 64628

This procedure involves the use of heat to disable the basivertebral nerve within the first two bones of your lower spine. It's done to alleviate chronic lower back pain. It's a safe, minimally invasive procedure with a quick recovery time.

26 services26 patients

Insertion or replacement of spinal neurostimulator generator or receiver 63685

The insertion of a spinal neurostimulator generator or receiver is a procedure to manage chronic pain. A small device is implanted under your skin, which sends mild electrical signals to your spinal cord. These signals disrupt pain signals, helping to reduce discomfort.

25 services25 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 Crater Lake Surgery Center LLC's NPI number?

The NPI number for Crater Lake Surgery Center LLC is 1679939318. It was assigned to this organization in the NPPES registry on January 11, 2016.

Where is Crater Lake Surgery Center LLC located?

Crater Lake Surgery Center LLC is located at 833 Bennett Ave, Medford, OR 97504. The listed phone number is (541) 779-5228.

What is Crater Lake Surgery Center LLC's specialty?

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

Is Crater Lake Surgery Center LLC enrolled in Medicare?

Yes. Crater Lake Surgery Center LLC is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Crater Lake Surgery Center LLC?

According to the CMS Revalidation Reassignment List (October 2026 release), 1 clinician (Physical Medicine and Rehabilitation) reassigns their Medicare billing to Crater Lake Surgery Center LLC. 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. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Does Crater Lake Surgery Center LLC hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 38D2149296) is associated with this NPI, valid through May 29, 2028. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

What insurance does Crater Lake Surgery Center LLC accept?

Health plans from BridgeSpan Health Company, Moda Health Plan, Inc., Providence Health Plan and Regence BlueCross BlueShield of Oregon list Crater Lake Surgery Center LLC 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 Crater Lake Surgery Center LLC was last updated on June 18, 2018. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 8 years 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.