AESTHETIC SURGERY CENTER OF WINTER PARK, LLC – Ambulatory Surgical Clinic/Center, NPI 1861653685

AESTHETIC SURGERY CENTER OF WINTER PARK, LLC is a healthcare provider. based in Winter park, Florida. specializing in Ambulatory Surgical Clinic/Center. The organization holds a License No. 1199 (FL). The NPI Number for AESTHETIC SURGERY CENTER OF WINTER PARK, LLC is 1861653685

Main info

Organization
Name
AESTHETIC SURGERY CENTER OF WINTER PARK, LLC
NPI
1861653685
Phone
(321) 282-0561
Address
4355 BEAR GULLY RD
Authorized Official
DR. JEFFREY M. HARTOG MEDICAL DIRECTOR D.M.D., M.D.
Enumeration Date
24 June 2008
Last Update Date
24 June 2008
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience48
Completeness75
Years active:17State licenses:1Digital endpointsOther names

Provider Addresses for AESTHETIC SURGERY CENTER OF WINTER PARK, LLC

  • 4355 BEAR GULLY RD

    WINTER PARK, FL 327929422

    Phone: (321) 282-0561

    Fax: (321) 282-0565

    Mailing address matches the actual address.

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: 2006-03-14

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

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
O20060314000247OAmbulatory Surgical CenterFLTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

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.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 32792)

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Reviews

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Frequently asked questions

What NPI should I save for AESTHETIC SURGERY CENTER OF WINTER PARK, LLC?
Save NPI 1861653685 if you need a stable reference for AESTHETIC SURGERY CENTER OF WINTER PARK, LLC.
Is AESTHETIC SURGERY CENTER OF WINTER PARK, LLC's enrollment marked active?
An active flag here means the NPI record is not in a deactivated state.
What kind of provider is AESTHETIC SURGERY CENTER OF WINTER PARK, LLC?
The page reflects Ambulatory Surgical Clinic/Center for AESTHETIC SURGERY CENTER OF WINTER PARK, LLC. Clinical services aligned with this taxonomy classification.
What location metadata exists for AESTHETIC SURGERY CENTER OF WINTER PARK, LLC?
The page summarizes Winter Park, Florida for AESTHETIC SURGERY CENTER OF WINTER PARK, LLC; expand the address list for detail.
How can I contact AESTHETIC SURGERY CENTER OF WINTER PARK, LLC?
Phone or fax may appear on the official NPI record when supplied — verify before relying on them.

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