BURNSIDE SURGERY CENTER LLC – NPI #1013417351
Clinic/Center

BURNSIDE SURGERY CENTER LLC is an AHC clinic located in GRESHAM, OR. NPPES has assigned the NPI number 1013417351 to BURNSIDE SURGERY CENTER LLC on February 13, 2018. It is a Type-2 NPI, indicating this NPI number is associated with an organization. With multiple taxonomy codes selected, the primary taxonomy selected by this provider is 261QA1903X from the Health Care Provider Taxonomy code set, which is classified as Clinic/Center, specializing in Ambulatory Surgical

The NPI profile was previously updated about 5 years ago on May 23, 2021. Use the NPI data found here to bill health insurance companies, identify providers enrolled in Medicare and Medicaid services or other HIPAA compliant transactions. See the complete NPI profile for BURNSIDE SURGERY CENTER LLC below.

NPI Profile for
BURNSIDE SURGERY CENTER LLC

NPI Number
1013417351
Enumeration Date

(more than 8 years ago)
Entity Type
Type-2  Organization
Organization health care providers may have a single employee or thousands of employees. An example is an incorporated individual who is an organization's only employee.
Legal Name
BURNSIDE SURGERY CENTER LLC
Primary location
689 NW BURNSIDE RD FL 1
GRESHAM, OR 97030-3739
Phone: (503) 382-8140 Fax:
Mailing address
Same as primary location
Organization Subpart
No
Authorized Official
OLEG MAKSIMOV
DIRECTOR
Phone: (503) 915-9217
Updated
Certification Date
May 23, 2021

Note: NPPES allows providers to attest to the accuracy of their NPI data. When a provider request any change to the NPI record, they will be able to attest to their changed NPI data, resulting in an updated certification date.

Taxonomy Code(s)

A taxonomy code is a code that describes the health care service provider's type, classification, and the area of specialization. The primary specialty for this provider is indicated as (Primary) below.

Taxonomy Classification / Specialization State License
261QA1903X
- Clinic/Center / Ambulatory Surgical (Primary)		 OR 07-1645
2081P2900X
- Physical Medicine & Rehabilitation / Pain Medicine		 OR MD28526

The taxonomy codes are selected by the provider at the time of NPI registration. Selection of a taxonomy code does not replace any credentialing or validation process that the provider requesting the code should complete.