Brandon Outpatient Surgery Center – Ambulatory Surgical Clinic/Center, NPI 1619049269

Brandon Outpatient Surgery Center is a healthcare provider. based in Brandon, Florida. specializing in Ambulatory Surgical Clinic/Center. The organization holds a License No. 1157 (FL). The NPI Number for Brandon Outpatient Surgery Center is 1619049269

Main info

Organization
Name
Brandon Outpatient Surgery Center
NPI
1619049269
Phone
(813) 684-7246
Address
201 NOLAND DRIVE
Authorized Official
DR. GEORGE S. SIDHOM MEDICAL DIRECTOR MD
Enumeration Date
15 November 2006
Last Update Date
8 November 2012
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience52
Completeness80
Years active:19State licenses:1Digital endpointsUpdated within 12 months

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Provider Addresses for Brandon Outpatient Surgery Center

  • 201, Noland Drive, Brandon, Hillsborough County, Florida, 33511, United States

    BRANDON, FL 335115728

    Phone: (813) 684-7246

    Fax: (302) 688-1113

    Type: Location

  • PO BOX 10390

    BROOKSVILLE, FL 346030390

    Phone: (352) 688-6393

    Fax: (352) 688-1113

    Type: Mailing

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2006-09-13

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Past revalidation due date

Earliest CMS due date was 2025-09-30 (252 days ago).

Enrollment records

1

Earliest due date

2025-09-30

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
O20060913000135OAmbulatory Surgical CenterFL2025-09-30

What to do next

  • Verify current status on the CMS Revalidation Lookup Tool immediately.
  • Complete revalidation in PECOS or contact your Medicare Administrative Contractor (MAC).
  • Overdue revalidation can lead to deactivation of Medicare billing privileges.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

Top Medicare procedures (2023) · refreshed 2026-05-27

HCPCSDescriptionServicesBeneficiariesMedicare allowed
64493Injection of lower or sacral spine facet joint using imaging guidance, single level7324$0
G0260Injection procedure for sacroiliac joint; provision of anesthetic, steroid and/or other therapeutic agent, with or without arthrography2612$0
64635Destruction of lower or sacral spinal facet joint nerves using imaging guidance, single facet joint2518$0
View full utilization report →

Insurance plans in this area (ZIP 33511)

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Reviews

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Frequently asked questions

What is Brandon Outpatient Surgery Center's NPI number?
Brandon Outpatient Surgery Center's NPI is 1619049269 — the number used across U.S. healthcare to identify this provider.
Is there an active status for Brandon Outpatient Surgery Center?
For scheduling context, Brandon Outpatient Surgery Center is shown as active in the registry.
How would a patient describe Brandon Outpatient Surgery Center's focus?
For Brandon Outpatient Surgery Center, the primary taxonomy reads as Ambulatory Surgical Clinic/Center. Clinical services aligned with this taxonomy classification.
What practice footprint exists for Brandon Outpatient Surgery Center?
Travel planning: use Brandon, Florida as the reference point for Brandon Outpatient Surgery Center, then confirm.
Does inactive status remove historical data?
Historical rows can remain visible after status changes — read the dates carefully.

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