CORAL DESERT SURGERY CENTER LLC NPI 1346205176

NPI Information

  • NPI: 1346205176
  • Provider Name: CORAL DESERT SURGERY CENTER LLC
  • Classification: Clinic/Center - 261QA1903X
  • Specialization: Ambulatory Surgical
  • Entity Type: Organization
  • CLIA Number: 46D1017025
  • Address: 1490 E FOREMASTER DR
    BUILDING C
    ST GEORGE, UT
    ZIP 84790
  • Phone: (435) 674-5230

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NPI Details

CORAL DESERT SURGERY CENTER LLC is an ambulatory surgical clinic center in St George, UT. CORAL DESERT SURGERY CENTER LLC NPI is 1346205176. The provider is registered as an organization entity type.

The provider's business location address is:

1490 E FOREMASTER DR
BUILDING C
ST GEORGE, UT
ZIP 84790-488
Phone: (435) 674-5230
Fax: (435) 674-5231

The provider's authorized official is Dan Nielson .
The authorized official title is Administrator and has the following contact phone number (435) 674-5230.

The CLIA number assigned to this NPI record is 46D1017025 - physician office 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, bupivacaine liposome, 1 mg (HCPCS:C9290)
  • Instillation, bupivacaine and meloxicam, 1 mg/0.03 mg (HCPCS:C9088)
  • Replacement of knee joint, both sides of knee (HCPCS:27447)
  • Shock wave crushing of kidney stones (HCPCS:50590)
  • Release of wrist ligament using an endoscope (HCPCS:29848)
  • Removal of knee cartilage using an endoscope (HCPCS:29881)
  • Removal of nasal air passage under lining tissue (HCPCS:30140)
  • Insertion of needle or tube into prostate for radiation therapy (HCPCS:55875)
  • Complex application of radiation source (HCPCS:77778)
  • Release and/or relocation of hand nerve (HCPCS:64721)
  • Destruction of lower or sacral spinal facet joint nerves using imaging guidance, single facet joint (HCPCS:64635)
  • Removal of both knee cartilages using an endoscope (HCPCS:29880)
  • Colorectal cancer screening; colonoscopy on individual not meeting criteria for high risk (HCPCS:G0121)
  • Repair of chronic torn shoulder rotator cuff (HCPCS:23412)
  • Biopsy of large bowel using a flexible endoscope (HCPCS:45380)
  • Removal of bone joints between wrist and fingers (HCPCS:25447)
  • Incision of tendon covering of finger (HCPCS:26055)
  • Removal of excessive skin and fat of upper eyelid (HCPCS:15823)
  • Repair of shoulder rotator cuff using an endoscope (HCPCS:29827)
  • Limited removal of abnormal shoulder joint tissue using endoscope (HCPCS:29822)
  • Removal of deep implant from bone (HCPCS:20680)
  • Placement of device in prostate for radiation therapy (HCPCS:55876)
  • Repair of groin hernia (5 years or older) (HCPCS:49505)
  • Incision of nasal sinus using an endoscope (HCPCS:31256)
  • Imaging of urinary tract following injection of a contrast agent (HCPCS:74420)
  • Correction of toe joint deformity (HCPCS:28285)
  • Repair of groin hernia using an endoscope (HCPCS:49650)
  • Reshaping of nasal cartilage (HCPCS:30520)
  • Release and/or relocation of elbow nerve (HCPCS:64718)
  • Biopsy of esophagus, stomach, and/or upper small bowel using a flexible endoscope (HCPCS:43239)
  • Relocation of tendon of forearm and/or wrist (HCPCS:25310)
  • Replacement of thigh bone and hip joint with prosthesis (HCPCS:27130)
  • Partial removal of collar bone at shoulder using an endoscope (HCPCS:29824)
  • Heat destruction of intraosseous basivertebral nerve in bones of spine in lower back, first two bones (HCPCS:64628)
  • Release of tendon connecting biceps muscle and shoulder using an endoscope (HCPCS:29828)
  • Insertion of stent in ureter using an endoscope (HCPCS:52332)
  • Repair of hernia at navel (5 years or older) (HCPCS:49585)
  • Removal of polyps or growths of large bowel using an endoscope with mechanical snare (HCPCS:45385)
  • Removal of extensive shoulder joint tissue using an endoscope (HCPCS:29823)
  • Replacement of knee joint on side of knee (HCPCS:27446)
  • Transfer of tendon to back of hand (HCPCS:26480)
  • Diagnostic exam of esophagus, stomach, and/or upper small bowel using a flexible endoscope (HCPCS:43235)
  • Removal of connective tissue of palm and release of finger, first digit (HCPCS:26123)

The enumeration date for this NPI number is 4/17/2006 and was last updated on 6/9/2017.

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:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1261QA1903XClinic/CenterAmbulatory Surgical2005-ASF-52092UTAHYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1P00085628OTHERUTAHRAILROAD MEDICARE
2838112MEDICAIDARIZONA
3000100081MEDICARE ID-TYPE UNSPECIFIEDUTAHUT MEDICARE
4=========001MEDICAIDUTAH

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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