Provider Demographics
NPI:1265442537
Name:BRIGHTON SURGERY CENTER, LLC
Entity Type:Organization
Organization Name:BRIGHTON SURGERY CENTER, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF OPERATING OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:R
Authorized Official - Last Name:WEIBEL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:585-295-8500
Mailing Address - Street 1:980 WESTFALL RD
Mailing Address - Street 2:SUITE 300
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14618-2605
Mailing Address - Country:US
Mailing Address - Phone:585-295-8500
Mailing Address - Fax:585-295-9300
Practice Address - Street 1:980 WESTFALL RD
Practice Address - Street 2:SUITE 300
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14618-2605
Practice Address - Country:US
Practice Address - Phone:585-295-8500
Practice Address - Fax:585-295-9300
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-09
Last Update Date:2024-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY2701237R261QA1903X
261QA1903X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02493438Medicaid
NY116227OtherPREFERRED CARE
NYP0140059BSOtherBLUE CROSS BLUE SHIELD
NYP0140059BSOtherBLUE CROSS BLUE SHIELD
NY2701237RMedicare UPIN
NYP0140059BSOtherBLUE CROSS BLUE SHIELD