PHYSICIANS SURGERY CENTER AT GOOD SAMARITAN LLC NPI 1285980151

NPI Details

PHYSICIANS SURGERY CENTER AT GOOD SAMARITAN, LLC is an ambulatory surgical clinic center in Mount Vernon, IL. PHYSICIANS SURGERY CENTER AT GOOD SAMARITAN, LLC NPI is 1285980151. The provider is registered as an organization entity type.
The provider Is Doing Business As Good Samaritan Surgery Center.

The provider's business location address is:

2 GOOD SAMARITAN WAY
STE 200
MOUNT VERNON, IL
ZIP 62864-476
Phone: (618) 899-5703
Fax: (618) 899-5704

The provider's authorized official is Joon Ahn .
The authorized official title is Authorized Official - Owner and has the following contact phone number (618) 899-5703.

The CLIA number assigned to this NPI record is 14D2047582 - 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, onabotulinumtoxina, 1 unit (HCPCS:J0585)
• Removal of cataract with insertion of prosthetic lens (HCPCS:66984)
• Release of wrist ligament using an endoscope (HCPCS:29848)
• Imaging of urinary tract following injection of a contrast agent (HCPCS:74420)
• Crushing of stone of ureter with insertion of stent using an endoscope (HCPCS:52356)
• Repair of shoulder rotator cuff using an endoscope (HCPCS:29827)
• Removal of polyps or growths of large bowel using a flexible endoscope with electrical cautery (HCPCS:45384)
• Exam with injections of chemical for destruction of bladder using an endoscope (HCPCS:52287)
• Incision of tendon covering of finger (HCPCS:26055)
• Biopsy of esophagus, stomach, and/or upper small bowel using a flexible endoscope (HCPCS:43239)

The enumeration date for this NPI number is 7/30/2012 and was last updated on 1/8/2025.

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: