MENTOR SURGERY CENTER LTD – Ambulatory Surgical Clinic/Center, NPI 1417958729

MENTOR SURGERY CENTER LTD is a healthcare provider. based in Mentor, Ohio. specializing in Ambulatory Surgical Clinic/Center. The organization holds a License No. 0404AS (OH). The NPI Number for MENTOR SURGERY CENTER LTD is 1417958729

Main info

Organization
Name
MENTOR SURGERY CENTER LTD
NPI
1417958729
Phone
(440) 205-5454
Address
9485 MENTOR AVE
Authorized Official
MISS TRACY ANN PETERS BUSINESS OFFICE MANAGER CPC
Enumeration Date
9 August 2005
Last Update Date
31 December 2014
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience54
Completeness75
Years active:20State licenses:1Digital endpointsOther names

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Provider Addresses for MENTOR SURGERY CENTER LTD

  • Lake Health Mentor Campus, 9485, Mentor Avenue, Mentor, Lake County, Ohio, 44060, United States

    STE 1

    MENTOR, OH 440608711

    Phone: (440) 205-5454

    Fax: (440) 205-5402

    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: 2009-07-27

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
O20090727000169OAmbulatory Surgical CenterOHTBD

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.

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

HCPCSDescriptionServicesBeneficiariesMedicare allowed
J0585Injection, onabotulinumtoxina, 1 unit2,30018$0
J1097Phenylephrine 10.16 mg/ml and ketorolac 2.88 mg/ml ophthalmic irrigation solution, 1 ml29250$0
66984Removal of cataract with insertion of prosthetic lens267144$0
66821Removal of recurring cataract in lens capsule using a laser13181$0
76000Imaging guidance for procedure, 60 minutes or less111106$0
View full utilization report →

Insurance plans in this area (ZIP 44060)

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Reviews

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Frequently asked questions

What is the 10-digit NPI for MENTOR SURGERY CENTER LTD?
MENTOR SURGERY CENTER LTD — NPI 1417958729 — is the standard way to identify this listing.
Does the file indicate MENTOR SURGERY CENTER LTD is practicing under active NPI?
Directory data currently reports MENTOR SURGERY CENTER LTD as active.
What is MENTOR SURGERY CENTER LTD's specialty?
The listing groups MENTOR SURGERY CENTER LTD with Ambulatory Surgical Clinic/Center. Clinical services aligned with this taxonomy classification.
What address line appears for MENTOR SURGERY CENTER LTD?
MENTOR SURGERY CENTER LTD's geographic hint is Mentor, Ohio in our summary view.
How many locations tie to this NPI?
2 practice locations appear in the available data.

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