GREAT LAKES AMBULATORY SURGERY CENTER – Ambulatory Surgical Clinic/Center, NPI 1023498219
Ambulatory Surgical Clinic/Center
Main info
Profile Insights
NPPES metrics only — not quality of care.
Provider Addresses for GREAT LAKES AMBULATORY SURGERY CENTER
2760 SOM CENTER RD
WILLOUGHBY HILLS, OH 440949111
Phone: (440) 306-2358
Fax: (440) 306-2359
Type: Mailing
9002 MENTOR AVE
MENTOR, OH 440606302
Phone: (440) 306-2358
Fax: (440) 306-2359
Type: Mailing
9002 MENTOR AVE STE B
MENTOR, OH 440606302
Phone: (440) 283-0244
Fax: (440) 283-0247
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: 2015-11-10
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
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| O20151110001580 | O | Ambulatory Surgical Center | OH | TBD |
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.
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
| HCPCS | Description | Services | Beneficiaries | Medicare allowed |
|---|---|---|---|---|
| 64493 | Injection of lower or sacral spine facet joint using imaging guidance, single level | 118 | 39 | $0 |
| 64490 | Injection of upper or middle spine facet joint using imaging guidance, single level | 64 | 24 | $0 |
| 62323 | Injection of substance into lower spine canal using imaging guidance | 55 | 48 | $0 |
| 64483 | Injection of anesthetic and/or steroid drug into sacral spine nerve root using imaging guidance, single level | 48 | 34 | $0 |
| 63650 | Insertion of spinal neurostimulator electrode array through skin | 43 | 14 | $0 |
Insurance plans in this area (ZIP 44094)
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