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Active NPI 1013417351 Organization (Entity Type 2)

Burnside Surgery Center Llc

Clinic/Center - Ambulatory Surgical • Gresham, OR

About Burnside Surgery Center Llc NPI 1013417351 Summary

Burnside Surgery Center Llc is a verified healthcare organization specializing in Clinic/Center - Ambulatory Surgical operating in Gresham, OR. Located at 689 NW BURNSIDE RD FL 1, this facility provides patient care and medical services under National Provider Identifier (NPI) 1013417351.

Administrative operations and authorized compliance are overseen by Oleg Maksimov (Director).

Facility Location & Contact Primary Location

Facility Address

689 Nw Burnside Rd Fl 1

Gresham, OR 970303739

Telephone 5033828140

Authorized Official Information

Authorized Contact Name

DR. Oleg Maksimov

Title / Role

Director

Official Telephone

5039159217

Facility Classifications & Specialties

Clinic/Center - Ambulatory Surgical Primary Taxonomy

NUCC Taxonomy Code: 261QA1903X

Definition to come...

Physical Medicine & Rehabilitation - Pain Medicine

NUCC Taxonomy Code: 2081P2900X

A physician who provides a high level of care, either as a primary physician or consultant, for patients experiencing problems with acute, chronic or cancer pain in both hospital and ambulatory settings. Patient care needs may also be coordinated with other specialists.

Facility & Registry History Timeline

Chronological log of verified NPI organization updates, branch relocations, and registry updates

6 Historical Events

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NPI Profile Active February 13, 2018

NPI status registered as active in NPPES database

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Updated Practice Location February 13, 2018

Registered at 689 NW BURNSIDE RD FL 1, GRESHAM, OR 970303739 (Tel: 5033828140)

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Updated Business Mailing Address February 13, 2018

Registered at 689 NW BURNSIDE RD FL 1, GRESHAM, OR 970303739

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Organization / Clinic Name Updated February 13, 2018

Operating as BURNSIDE SURGERY CENTER LLC

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Medical Taxonomy / Specialty Registered (Primary Specialty) February 13, 2018

Physical Medicine & Rehabilitation (License #MD28526 in OR)

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Initial NPI Registration & Enumeration February 13, 2018

First registered as active Healthcare Organization in NPPES Database.

Patient & Community Reviews

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NPI Organization Metadata

NPI Number: 1013417351

Entity Type:

Organization Organization (Hospital, Clinic, Group Practice) (Type 2 NPI)

Enumeration Date: February 13, 2018

Last Update: May 23, 2021

Update or Correct Listing

Mailing Address

689 Nw Burnside Rd Fl 1

Gresham, OR 970303739

Public Domain Record This organization profile is sourced from public domain datasets published by CMS and NPPES under FOIA.

⚠️ Medical Disclaimer

Facility details are provided for public information only. In case of a medical emergency, call 911 immediately.