UPSTATE SURGERY CENTER LLC NPI 1619998523

NPI Information

  • NPI: 1619998523
  • Provider Name: UPSTATE SURGERY CENTER, LLC
  • Classification: Clinic/Center - 261QA1903X
  • Specialization: Ambulatory Surgical
  • Entity Type: Organization
  • CLIA Number: 42D0883226
  • Address: 10 ENTERPRISE BLVD
    SUITE 104
    GREENVILLE, SC
    ZIP 29615
  • Phone: (864) 458-7141

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NPI Details

UPSTATE SURGERY CENTER, LLC is an ambulatory surgical clinic center in Greenville, SC. UPSTATE SURGERY CENTER, LLC NPI is 1619998523. The provider is registered as an organization entity type.

The provider's business location address is:

10 ENTERPRISE BLVD
SUITE 104
GREENVILLE, SC
ZIP 29615-301
Phone: (864) 458-7141
Fax: (864) 676-9116

The provider's authorized official is Raymond Mcculloch .
The authorized official title is Controller and has the following contact phone number (864) 282-4910.

The CLIA number assigned to this NPI record is 42D0883226 - 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.

  • Removal of cataract with insertion of prosthetic lens (HCPCS:66984)
  • Repair of tendon of upper eyelid (HCPCS:67904)
  • Complex removal of cataract with insertion of prosthetic lens (HCPCS:66982)
  • Removal of excessive skin and fat of upper eyelid (HCPCS:15823)
  • Destruction of lens tissue using laser (HCPCS:66710)
  • Creation of shunt to improve eye fluid flow using tissue graft (HCPCS:66180)
  • Dilation to improve eye fluid flow (HCPCS:66174)
  • Extensive repair of turning-outward eyelid defect (HCPCS:67917)
  • Repair of wound of eyelids, nose, ears, or lips by transferring skin, 10.0 sq cm or less (HCPCS:14060)

The enumeration date for this NPI number is 7/23/2006 and was last updated on 6/3/2008.

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 SurgicalASF-050SOUTH CAROLINAYes

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
1Q326080001MEDICARE PINSOUTH CAROLINA
2ASC028MEDICAIDSOUTH CAROLINA

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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