Black River Ambulatory Surgery Center, LLC
NPI 1770149304 · Ambulatory Surgical Clinic/Center · Poplar Bluff, MO
Black River Ambulatory Surgery Center, LLC is a Ambulatory Surgical Clinic/Center organization in Poplar Bluff, MO (NPI 1770149304).
Provider details
- NPI number
- 1770149304
- Entity type
- Organization
- Primary specialty
- Ambulatory Surgical Clinic/CenterAmbulatory Health Care Facilities
- Organization subpart
- No
- Authorized official
- David Prather, Chief Financial Officer(573) 331-5129
Specialties & taxonomies
Ambulatory Health Care Facilities
- Multi-Specialty Clinic/Center261QM1300X
Ambulatory Health Care Facilities
Profile Score
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure28% of score
7 yrs in NPPES registry
- Profile completeness28% of score
100% of core fields populated
- Practice footprint17% of score
1 documented practice location
- Medicare service volume (vs. specialty peers)28% of score
937 Medicare services, 2024 (ranked within specialty)
Medicare volume is ranked against active providers in the same specialty. Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
What this provider does (Medicare)
Based on Medicare fee-for-service claims, 2024; not all care is captured.
| Service (HCPCS) | Medicare services | Typical Medicare-allowed (2024) |
|---|---|---|
| Removal of Cataract With Insertion of Prosthetic Lens66984 | 340 | $1,019 |
| Biopsy of Esophagus, Stomach, And/Or Upper Small Bowel Using a Flexible Endoscope43239 | 136 | $280 |
| Biopsy of Large Bowel Using a Flexible Endoscope45380 | 132 | $432 |
| Removal of Polyps Or Growths of Large Bowel Using an Endoscope With Mechanical Snare45385 | 117 | $523 |
| Complex Removal of Cataract With Insertion of Prosthetic Lens66982 | 66 | $995 |
Practice location
Mailing address
Registry dates
- Enumerated
- 2019-05-20
- Last updated
- 2019-05-20
Frequently asked questions
- What is Black River Ambulatory Surgery Center, LLC's NPI number?
- Black River Ambulatory Surgery Center, LLC's National Provider Identifier (NPI) is 1770149304, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What type of organization is Black River Ambulatory Surgery Center, LLC?
- Black River Ambulatory Surgery Center, LLC is classified in the NPPES registry as Ambulatory Surgical Clinic/Center (Ambulatory Health Care Facilities).
- Where is Black River Ambulatory Surgery Center, LLC located?
- Black River Ambulatory Surgery Center, LLC's practice location on file with NPPES is 219 Physicians Park, Poplar Bluff, MO 63901-3956.
- What is Black River Ambulatory Surgery Center, LLC's phone number?
- The practice phone number listed in the NPPES registry for Black River Ambulatory Surgery Center, LLC is (573) 609-2444.
- Who is the authorized official for Black River Ambulatory Surgery Center, LLC?
- The authorized official listed on Black River Ambulatory Surgery Center, LLC's NPPES record is David Prather, Chief Financial Officer. The authorized official registers and maintains the organization's NPI and is not necessarily its owner.
- Is Black River Ambulatory Surgery Center, LLC's NPI active?
- Yes — Black River Ambulatory Surgery Center, LLC's NPI (1770149304) is active in the NPPES registry as of the last update on 2019-05-20.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.