LAKE RIDGE SURGERY CENTER
NPI 1972850808
Clinic/Center - Ambulatory Surgical in Woodbridge, VA

NPI Status: Active since August 09, 2012

Contact Information

12825 MINNIEVILLE ROAD
SUITE 204
WOODBRIDGE, VA
ZIP 22192
Phone: (703) 357-9568
Fax: (703) 357-9575

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  • Organization
  • Clinic/Center
  • Ambulatory Surgical
  • CLIA Number: 49D2050068
  • CLIA Cert. Type: Ambulatory Surgery Center
  • CLIA Exp. Date: 11-18-2026

About LAKE RIDGE SURGERY CENTER

This page provides the complete NPI Profile along with additional information for Lake Ridge Surgery Center, a provider established in Woodbridge, Virginia operating as a Clinic/center, focusing in ambulatory surgical . The healthcare provider is registered in the NPI registry with number 1972850808 assigned on August 2012. The practitioner's primary taxonomy code is 261QA1903X. The provider is registered as an organization and their NPI record was last updated 12 years ago. The provider's is doing business as Lake Ridge Surgery Center. The authorized official of this NPI record is Mrs. Janet M Smith Rn (Administrator)

NPI
1972850808
Provider Legal Name
LAKE RIDGE AMBULATORY SURGERY CENTER, LLC
Other Organization Name
LAKE RIDGE SURGERY CENTER
Other Name Type
Doing Business As (3)
Entity Type
Organization
Location Address
12825 MINNIEVILLE ROAD SUITE 204 WOODBRIDGE, VA 22192
Location Phone
(703) 357-9568
Location Fax
(703) 357-9575
Mailing Address
12825 MINNIEVILLE ROAD SUITE 204 WOODBRIDGE, VA 22192
Mailing Phone
(703) 357-9568
Mailing Fax
(703) 357-9575
Is Sole Proprietor?
No
Is Organization Subpart?
No
Enumeration Date
08-09-2012
Last Update Date
12-27-2013
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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:

Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.

Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.

*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

MRS. JANET M SMITH RN

Authorized Official Title
ADMINISTRATOR
Authorized Official Phone
(703) 357-9568

Additional Identifiers

The NPI Enumerator encourages providers to submit additional identifiers with their NPI application although the submission of this information is optional. The additional identifier(s) section includes other numbers or codes currently or formerly used as an identifier for the provider by other public healthcare entities. The identifiers may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.

Identifier Type / Code Identifier State Identifier Issuer
Q409820001MEDICARE PIN (08)VA 

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.

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 21 times for 14 patients

Release of tendon connecting biceps muscle and shoulder using an endoscope

This procedure involves using a small camera, known as an endoscope, to view and release the tendon connecting your biceps muscle and shoulder. It can help reduce pain and improve mobility. The procedure is minimally invasive, promoting quicker recovery.

This service was performed 19 times for 19 patients

Removal of extensive shoulder joint tissue using an endoscope

This procedure, known as arthroscopic debridement, involves using a small camera (endoscope) to view your shoulder joint. Damaged or unwanted tissue is then carefully removed. This minimally invasive technique aims to reduce pain and improve joint mobility.

This service was performed 12 times for 12 patients

Repair of shoulder rotator cuff using an endoscope

This procedure, known as arthroscopic rotator cuff repair, helps fix tears in the shoulder's rotator cuff. An endoscope, a small camera, is used to view the shoulder inside. Using small tools, the surgeon repairs the torn tissue. This minimally invasive approach often leads to a quicker recovery.

This service was performed 23 times for 23 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
49D2050068
Facility Type
Ambulatory Surgery Center
Certificate Effective Date
November 19, 2024
Certificate Expiration Date
November 18, 2026
Laboratory Director
JANETTE A. BELTRAN
Certificate Type
Certificate of Waiver
Certificate Type Description
This CLIA certificate is issued to Lake Ridge Surgery Center 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 1972850808, we treat the final digit (8) 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 62. The final step is to find the difference between that total and the next multiple of ten (70 - 62 = 8).

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
9
Unchanged
Pos 3
7
Doubled → 14 → 1 + 4
Pos 4
2
Unchanged
Pos 5
8
Doubled → 16 → 1 + 6
Pos 6
5
Unchanged
Pos 7
0
Doubled → 0
Pos 8
8
Unchanged
Pos 9
0
Doubled → 0
Check
8
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 7 → 14 → 5 8 → 16 → 7 0 → 0 0 → 0

Step 2: Add all digits plus the NPI constant

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

2 + 9 + 1 + 4 + 2 + 1 + 6 + 5 + 0 + 8 + 0 + 24 = 62

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

The next multiple of ten after 62 is 70. The difference is the calculated check digit.

70 - 62 = 8
This NPI is valid
The calculated check digit is 8, which matches the last digit of 1972850808.

Other Providers at the Same Location


The following 4 providers are registered at the same or a nearby location.

Clinic/Center
12825 MINNIEVILLE ROAD
LAKE RIDGE, VA 22192
Physical Therapist
12825 MINNIEVILLE ROAD, SUITE 203
WOODBRIDGE, VA 22192
Orthopaedic Surgery
12825 MINNIEVILLE ROAD, SUITE 201/203
WOODBRIDGE, VA 22192
Anesthesiology
12825 MINNIEVILLE ROAD, # 220
WOODBRIDGE, VA 22192

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1972850808, enumerated as an "organization" on August 09, 2012.

The provider is located at 12825 MINNIEVILLE ROAD SUITE 204 WOODBRIDGE, VA 22192 and the phone number is (703) 357-9568.

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

The provider might be accepting Accepts: Medicare and Medicaid. Please consult your insurance carrier or call the provider to verify.