Pensacola Children's Surgery Center – Ambulatory Surgical Clinic/Center, NPI 1205839487

Pensacola Children's Surgery Center is a healthcare provider. based in Spring, Texas. specializing in Ambulatory Surgical Clinic/Center. The organization holds a License No. 1061 (FL). The NPI Number for Pensacola Children's Surgery Center is 1205839487

Main info

Organization
Name
Pensacola Children's Surgery Center
NPI
1205839487
Phone
(713) 489-2198
Address
9709 LAKESIDE BLVD STE 350
Authorized Official
DEVIN LARSEN CEO
Enumeration Date
23 May 2005
Last Update Date
16 March 2026
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience64
Completeness90
Years active:21State licenses:1Digital endpoints

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Provider Addresses for Pensacola Children's Surgery Center

  • 9709 LAKESIDE BLVD STE 350

    SPRING, TX 773811216

    Phone: (713) 489-2198

    Fax: (713) 489-2978

    Type: Mailing

  • 1549, Airport Boulevard, Cordova Commons, Pensacola, Escambia County, Florida, 32504, United States of America

    STE 420

    PENSACOLA, FL 325048633

    Phone: (850) 484-8800

    Fax: (850) 484-6020

    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: 2004-10-05

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
O20041005001240OAmbulatory 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.

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

HCPCSDescriptionServicesBeneficiariesMedicare allowed
64635Destruction of lower or sacral spinal facet joint nerves using imaging guidance, single facet joint2813$0
View full utilization report →

Insurance plans in this area (ZIP 77381)

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Reviews

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Frequently asked questions

How is Pensacola Children's Surgery Center identified in CMS data?
CMS-hosted NPPES data lists Pensacola Children's Surgery Center with NPI 1205839487.
Does the file indicate Pensacola Children's Surgery Center is practicing under active NPI?
Directory data currently reports Pensacola Children's Surgery Center as active.
What is Pensacola Children's Surgery Center's primary classification?
Ambulatory Surgical Clinic/Center is the headline specialty for Pensacola Children's Surgery Center here. Clinical services aligned with this taxonomy classification.
Where is Pensacola Children's Surgery Center based?
Pensacola Children's Surgery Center is tied to Spring, Texas in the data we show; additional addresses may exist on the full record.
Why does Pensacola Children's Surgery Center have multiple addresses?
3 practice locations appear in the available data. Multiple addresses are common for hospital privileges, telehealth, or multi-site groups.

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