BURNSIDE SURGERY CENTER LLC NPI 1013417351

NPI Details

BURNSIDE SURGERY CENTER LLC is an ambulatory surgical clinic center in Gresham, OR. BURNSIDE SURGERY CENTER LLC NPI is 1013417351. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

689 NW BURNSIDE RD FL 1
GRESHAM, OR
ZIP 97030-739
Phone: (503) 382-8140

The provider's authorized official is Oleg Maksimov .
The authorized official title is Director and has the following contact phone number (503) 915-9217.

The CLIA number assigned to this NPI record is 38D2150925 - ambulatory surgery center with a certificate type of Certificate of Waiver.

The following top HCPCS codes were publicly reported for this provider under the Medicare program for the year 2016. The reported codes are based on the top codes for each available Medicare specialty, excluding evaluation and management codes.

• Injection of lower or sacral spine facet joint using imaging guidance, single level (HCPCS:64493)
• Injection of anesthetic and/or steroid drug into sacral spine nerve root using imaging guidance, single level (HCPCS:64483)
• Destruction of lower or sacral spinal facet joint nerves using imaging guidance, single facet joint (HCPCS:64635)
• Aspiration and/or injection of fluid from large joint (HCPCS:20610)
• Injection procedure for sacroiliac joint; provision of anesthetic, steroid and/or other therapeutic agent, with or without arthrography (HCPCS:G0260)
• Injection of upper or middle spine facet joint using imaging guidance, single level (HCPCS:64490)
• Destruction of upper or middle spinal facet joint nerves using imaging guidance, single facet joint (HCPCS:64633)

The enumeration date for this NPI number is 2/13/2018 and was last updated on 5/23/2021.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available: