FKP TAMPA AMBULATORY SURGERY CENTER, LLC – Ambulatory Surgical Clinic/Center, NPI 1205600806

FKP TAMPA AMBULATORY SURGERY CENTER, LLC is a healthcare provider. based in Deerfield, Illinois. specializing in Ambulatory Surgical Clinic/Center. The NPI Number for FKP TAMPA AMBULATORY SURGERY CENTER, LLC is 1205600806

Main info

Organization
Name
FKP TAMPA AMBULATORY SURGERY CENTER, LLC
NPI
1205600806
Phone
(847) 388-2064
Address
1 PARKWAY NORTH BLVD STE 200S
Authorized Official
LAUREN ELLENBURG CHIEF OF PROVIDER GROUP OPERATIONS
Enumeration Date
14 November 2023
Last Update Date
20 August 2025
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience19
Completeness85
Years active:2State licenses:0Digital endpointsOther names

Provider Addresses for FKP TAMPA AMBULATORY SURGERY CENTER, LLC

  • 1 PARKWAY NORTH BLVD STE 200S

    DEERFIELD, IL 600152534

    Phone: (847) 388-2064

    Type: Mailing

  • 514 EICHENFELD DR

    BRANDON, FL 335115955

    Phone: (813) 358-1568

    Fax: (813) 200-1840

    Type: Location

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: 2024-08-30

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
O20240830000460OAmbulatory 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 60015)

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Reviews

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Frequently asked questions

Is there an official ID for FKP TAMPA AMBULATORY SURGERY CENTER, LLC in U.S. healthcare records?
The official identifier for FKP TAMPA AMBULATORY SURGERY CENTER, LLC is NPI 1205600806.
Is FKP TAMPA AMBULATORY SURGERY CENTER, LLC still an active registrant?
FKP TAMPA AMBULATORY SURGERY CENTER, LLC carries an active NPI according to the public dataset.
What expertise is attributed to FKP TAMPA AMBULATORY SURGERY CENTER, LLC?
FKP TAMPA AMBULATORY SURGERY CENTER, LLC's specialty line reads Ambulatory Surgical Clinic/Center. Clinical services aligned with this taxonomy classification.
Where in Illinois is FKP TAMPA AMBULATORY SURGERY CENTER, LLC registered?
Use Deerfield, Illinois as the headline location for FKP TAMPA AMBULATORY SURGERY CENTER, LLC here.
When was this NPI issued?
Enumeration for FKP TAMPA AMBULATORY SURGERY CENTER, LLC is noted as November 14, 2023 where the registry provides it.

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