KENOSHA SURGICENTER LLC
NPI 1760101992
Non-Pharmacy Dispensing Site in Kenosha, WI
NPI Status: Active since August 23, 2022
Contact Information
10105 74TH ST STE 102
KENOSHA, WI
ZIP 53142
Phone: (262) 297-7246
Fax: (888) 701-0578
- Organization
- Non-Pharmacy Dispensing Site
- CLIA Number: 52D2293764
- CLIA Cert. Type: Ambulatory Surgery Center
- CLIA Exp. Date: 11-13-2027
About KENOSHA SURGICENTER LLC
This page provides the complete NPI Profile along with additional information for Kenosha Surgicenter Llc, a provider established in Kenosha, Wisconsin operating as a Non-pharmacy Dispensing Site. The healthcare provider is registered in the NPI registry with number 1760101992 assigned on August 2022. The practitioner's primary taxonomy code is 332900000X. The provider is registered as an organization and their NPI record was last updated 4 years ago. The authorized official of this NPI record is Kevin Eugene Hooker (Hr)
- NPI
- 1760101992
- Provider Name
- KENOSHA SURGICENTER LLC
- Entity Type
- Organization
- Location Address
- 10105 74TH ST STE 102 KENOSHA, WI 53142
- Location Phone
- (262) 297-7246
- Location Fax
- (888) 701-0578
- Mailing Address
- 2500 W LAYTON AVE STE 120 MILWAUKEE, WI 53221
- Mailing Phone
- (262) 297-7246
- Is Sole Proprietor?
- No
- Is Organization Subpart?
- No
- Enumeration Date
- 08-23-2022
- Last Update Date
- 08-23-2022
- Code Navigator
Location Map
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
Non-Pharmacy Dispensing Site
- Taxonomy Code
- 332900000X
- Type
- Suppliers
- Taxonomy Description
- A site other than a pharmacy that dispenses medicinal preparations under the supervision of a physician to patients for self-administration. (e.g. physician offices, ER, Urgent Care Centers, Rural Health Facilities, etc.)
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
- 52D2293764
- Facility Type
- Ambulatory Surgery Center
- Certificate Effective Date
- November 14, 2025
- Certificate Expiration Date
- November 13, 2027
- Laboratory Director
- DR. KOSTANDINOS TSOULFAS
- Certificate Type
- Certificate of Waiver
- Certificate Type Description
- This CLIA certificate is issued to Kenosha Surgicenter 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 1760101992, we treat the final digit (2) 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 58. The final step is to find the difference between that total and the next multiple of ten (60 - 58 = 2).
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.
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.
Step 2: Add all digits plus the NPI constant
Add the transformed values, the unchanged digits, and the constant 24.
Step 3: Find the amount needed to reach the next multiple of 10
The next multiple of ten after 58 is 60. The difference is the calculated check digit.
Other Providers at the Same Location
The following 4 providers are registered at the same or a nearby location.
KENOSHA, WI 53142
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1760101992, enumerated as an "organization" on August 23, 2022.
The provider is located at 10105 74TH ST STE 102 KENOSHA, WI 53142 and the phone number is (262) 297-7246.
Non-Pharmacy Dispensing Site with taxonomy code 332900000X.
