GREAT LAKES SURGICAL CENTER LLC
NPI 1568420388
Clinic/Center - Ambulatory Surgical in Southfield, MI

NPI Status: Active since May 02, 2006

Contact Information

26051 LAHSER RD
SOUTHFIELD, MI
ZIP 48034
Phone: (248) 223-9925
Fax: (248) 223-9957

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  • Organization
  • Clinic/Center
  • Ambulatory Surgical
  • Accepts Insurance
  • CLIA Number: 23D1036250
  • CLIA Cert. Type: Ambulatory Surgery Center
  • CLIA Exp. Date: 01-24-2027

About GREAT LAKES SURGICAL CENTER LLC

This page provides the complete NPI Profile along with additional information for Great Lakes Surgical Center Llc, a provider established in Southfield, Michigan operating as a Clinic/center, focusing in ambulatory surgical . The healthcare provider is registered in the NPI registry with number 1568420388 assigned on May 2006. The practitioner's primary taxonomy code is 261QA1903X with license number 261QA1903X (MI). The provider is registered as an organization and their NPI record was last updated 17 years ago. The authorized official of this NPI record is Dr. Keith M Metz M.d. (Medical Director)

NPI
1568420388
Provider Name
GREAT LAKES SURGICAL CENTER LLC
Entity Type
Organization
Location Address
26051 LAHSER RD SOUTHFIELD, MI 48034
Location Phone
(248) 223-9925
Location Fax
(248) 223-9957
Mailing Address
26051 LAHSER RD SOUTHFIELD, MI 48034
Mailing Phone
(248) 223-9925
Mailing Fax
(248) 223-9957
Is Sole Proprietor?
No
Is Organization Subpart?
No
Enumeration Date
05-02-2006
Last Update Date
04-20-2008
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Specialty - Primary Taxonomy

The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Classification

Clinic/Center Ambulatory Surgical

Taxonomy Code
261QA1903X
Type
Ambulatory Health Care Facilities
License No.
261QA1903X
License State
MI

Insurance Plans Accepted

According to publicly available information the provider might be accepting the following health plans from these health insurance companies:

  • Clear Silver - HMO
  • Elite Bronze - HMO
  • Elite Bronze + Vision + Adult Dental - HMO
  • Elite Gold - HMO
  • Elite Gold + Vision + Adult Dental - HMO
  • Everyday Bronze - HMO
  • Everyday Bronze + Vision + Adult Dental - HMO
  • Everyday Gold - HMO
  • Everyday Gold + Vision + Adult Dental - HMO
  • Focused Silver - HMO
  • Focused Silver + Vision + Adult Dental - HMO
  • Standard Expanded Bronze - HMO
  • Standard Expanded Bronze + Vision + Adult Dental - HMO
  • Standard Gold - HMO
  • Standard Gold + Vision + Adult Dental - HMO
  • Standard Silver - HMO
  • Standard Silver + Vision + Adult Dental - HMO
  • Choice Bronze HSA - HMO
  • Choice Bronze HSA + Vision + Adult Dental - HMO
  • Clear Gold - HMO
  • Clear Gold + Vision + Adult Dental - HMO
  • Clear Silver - HMO
  • Complete Gold - HMO
  • Complete Gold + Vision + Adult Dental - HMO
  • Complete Silver - HMO
  • Complete Silver + Vision + Adult Dental - HMO
  • Elite Gold - HMO
  • Elite Gold + Vision + Adult Dental - HMO
  • Everyday Bronze - HMO
  • Everyday Bronze + Vision + Adult Dental - HMO
  • Focused Silver - HMO
  • Focused Silver + Vision + Adult Dental - HMO
  • Standard Expanded Bronze - HMO
  • Standard Expanded Bronze + Vision + Adult Dental - HMO
  • Standard Gold - HMO
  • Standard Gold + Vision + Adult Dental - HMO
  • Standard Silver - HMO
  • Blue Cross� Local HMO Bronze Extra - HMO
  • Blue Cross� Local HMO Bronze Secure - HMO
  • Blue Cross� Local HMO Silver Extra - HMO
  • Blue Cross� Local HMO Silver Saver - HMO
  • Blue Cross� Preferred HMO Bronze Extra - HMO
  • Blue Cross� Preferred HMO Bronze Saver HSA - HMO
  • Blue Cross� Preferred HMO Bronze Secure - HMO
  • Blue Cross� Preferred HMO Gold - HMO
  • Blue Cross� Preferred HMO Gold Extra - HMO
  • Blue Cross� Preferred HMO Silver - HMO
  • Blue Cross� Preferred HMO Silver Extra - HMO
  • Blue Cross� Preferred HMO Silver Saver - HMO
  • Blue Cross� Preferred HMO Value - HMO
  • Blue Cross� Select HMO Bronze Extra - HMO
  • Blue Cross� Select HMO Bronze Saver HSA - HMO
  • Blue Cross� Select HMO Bronze Secure - HMO
  • Blue Cross� Select HMO Silver - HMO
  • Blue Cross� Select HMO Silver Extra - HMO
  • Blue Cross� Select HMO Silver Saver - HMO
  • Blue Cross� Select HMO Value - HMO
  • Blue Cross� Premier PPO Bronze Extra - PPO
  • Blue Cross� Premier PPO Bronze HSA - PPO
  • Blue Cross� Premier PPO Bronze Secure - PPO
  • Blue Cross� Premier PPO Gold - PPO
  • Blue Cross� Premier PPO Gold Extra - PPO
  • Blue Cross� Premier PPO Silver - PPO
  • Blue Cross� Premier PPO Silver Extra - PPO
  • Blue Cross� Premier PPO Silver Saver HSA - PPO
  • Blue Cross� Premier PPO Value - PPO
  • Bronze First - HMO
  • Bronze First Adult Vision & Fitness - HMO
  • Diabetes Gold - HMO
  • Diabetes Gold Adult Vision & Fitness - HMO
  • Diabetes Silver - HMO
  • Diabetes Silver Adult Vision & Fitness - HMO
  • Gold - HMO
  • Gold Adult Vision & Fitness - HMO
  • HDHP Preventive Silver - HMO
  • Healthy Heart Gold - HMO
  • Healthy Heart Gold Adult Vision & Fitness - HMO
  • Healthy Heart Silver - HMO
  • Healthy Heart Silver Adult Vision & Fitness - HMO
  • Low Premium Silver - HMO
  • Low Premium Silver Adult Vision & Fitness - HMO
  • Silver - HMO
  • Silver Adult Vision & Fitness - HMO
  • MHP Bronze - HMO
  • MHP Bronze Saver (Expanded) - HMO
  • MHP Expanded Bronze Standard - HMO
  • MHP Gold - HMO
  • MHP Gold Standard - HMO
  • MHP Silver Exchange - HMO
  • MHP Silver Exchange Rewards - HMO
  • MHP Silver Standard - HMO
  • MHP Young Adult/Catastrophic - HMO
  • MyPriority Balanced Silver - HMO
  • MyPriority Balanced Silver Southeast Michigan Network - HMO
  • MyPriority Balanced Silver Trinity Health East Network - HMO
  • MyPriority Enhanced Gold Southeast Michigan Network - HMO
  • MyPriority Enhanced Gold Trinity Health East Network - HMO
  • MyPriority Premier Silver - HMO
  • MyPriority Premier Silver Southeast Michigan Network - HMO
  • MyPriority Premier Silver Trinity Health East Network - HMO
  • MyPriority Standard Bronze - HMO
  • MyPriority Standard Bronze - Southeast Michigan Network - HMO
  • MyPriority Standard Bronze - Travel - HMO
  • MyPriority Standard Bronze - Trinity Health East Network - HMO
  • MyPriority Standard Gold - HMO
  • MyPriority Standard Gold Southeast Michigan Network - HMO
  • MyPriority Standard Gold Trinity Health East Network - HMO
  • MyPriority Standard Silver - HMO
  • MyPriority Standard Silver - Southeast Michigan Network - HMO
  • MyPriority Standard Silver - Travel - HMO
  • MyPriority Standard Silver - Trinity Health East Network - HMO
  • MyPriority Value Bronze - HMO

Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.

Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.

Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.

*Please verify directly with this provider to make sure your insurance plan is currently accepted.

Authorized Official

The authorized official is the designated individual with the legal authority to make changes to the provider’s official NPI record. For organizations, the authorized official must be a general partner, chairman of the board, CEO, CFO or a direct owner holding at least a 5 percent stake in the medical organization.

Authorized Official Name

DR. KEITH M METZ M.D.

Authorized Official Title
MEDICAL DIRECTOR
Authorized Official Phone
(248) 223-9925

Additional Identifiers

The NPI Enumerator encourages providers to submit additional identifiers with their NPI application although the submission of this information is optional. The additional identifier(s) section includes other numbers or codes currently or formerly used as an identifier for the provider by other public healthcare entities. The identifiers may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.

Identifier Type / Code Identifier State Identifier Issuer
=========OTHER (01)MICOMMERCIAL CLAIMS
0P20050MEDICARE ID-TYPE UNSPECIFIED (04)MIMEDICARE
40332OTHER (01)MIBLUE CROSS PRIMARY
17228OTHER (01)MIMCARE

Areas of Expertise

The following services and procedures, recently provided to Medicare patients, illustrate the range of care this provider offers. This list reflects the variety of services available to all patients visiting the practice and is based on 2022 Medicare dataset. In general, the more frequently a provider treats specific conditions or performs particular procedures, the more experienced they become in addressing similar patient needs. The provider has delivered many of the services listed below to Medicare patients. Please note that this list does not include services provided to patients who are not covered by Medicare.

Complete exam of nose and sinuses using an endoscope

This procedure involves inserting a thin tube with a light (endoscope) into the nose to examine the nasal passages and sinuses. It helps identify any abnormalities or issues. The process is safe, usually painless, and provides valuable information for your care.

This service was performed 23 times for 13 patients

Removal of cataract with insertion of prosthetic lens

This is a procedure where a cloudy lens in your eye, known as a cataract, is removed. After removal, a clear artificial lens is inserted. This helps to restore your vision, enabling you to see clearly again.

This service was performed 79 times for 46 patients

Removal of nasal air passage under lining tissue

This procedure, often done to improve breathing or address sinus issues, involves the removal of tissue from the lining of the nasal air passage. It's performed under anesthesia and recovery time varies based on individual health status.

This service was performed 51 times for 26 patients

Removal of nasal sinus tissue using an endoscope

This procedure, known as endoscopic sinus surgery, involves using a thin, flexible tube with a light and camera to view and remove problematic nasal sinus tissue. It helps to alleviate sinus issues and improve breathing.

This service was performed 29 times for 17 patients

Reshaping of nasal cartilage

Reshaping of nasal cartilage, also known as rhinoplasty, is a surgical procedure to modify the structure of the nose for aesthetic or functional purposes. It involves adjusting the cartilage and bone in the nose to achieve the desired shape or to improve breathing.

This service was performed 23 times for 23 patients

CLIA Information

The Clinical Laboratory Improvement Amendments (CLIA) of 1988 applies to facilities or sites that test human specimens for health assessment or to diagnose, prevent, or treat disease. The CLIA Program sets standards for clinical laboratory testing and issues certificates. The NPI / CLIA crosswalk information for this NPI number is:

CLIA Number
23D1036250
Facility Type
Ambulatory Surgery Center
Certificate Effective Date
January 25, 2025
Certificate Expiration Date
January 24, 2027
Laboratory Director
RICHARD E. HAN
Certificate Type
Certificate of Waiver
Certificate Type Description
This CLIA certificate is issued to Great Lakes Surgical Center Llc to perform only waived tests. CLIA defines waived tests as simple tests with a low risk for an incorrect result. Waived tests include certain tests listed in CLIA regulations, tests cleared by the FDA for home use and tests approved by the FDA for waived status and that meet CLIA waiver criteria.

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NPI Validation Check Digit Calculation


The following table explains the step by step NPI number validation process using the ISO standard Luhn algorithm.

Start with the original NPI number, the last digit is the check digit and is not used in the calculation.
1568420388
Step 1: Double the value of the alternate digits, beginning with the rightmost digit.
25128820316
Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24.
2 + 5 + 1 + 2 + 8 + 8 + 2 + 0 + 3 + 1 + 6 + 24 = 62
Step 3: Subtract the total obtained in step 2 from the next higher number ending in zero, the result is the check digit.
70 - 62 = 88

The NPI number 1568420388 is valid because the calculated check digit 8 using the Luhn validation algorithm matches the last digit of the original NPI number.

Other Providers at the Same Location


The following 4 providers are registered at the same or nearby location.

NPI Name / Type Taxonomy Address
1053353847GREAT LAKES SURGICAL CENTER ANESTHESIA, PLC
Organization
Anesthesiology26051 LAHSER RD
SOUTHFIELD, MI 48034
(248) 223-9945
1609982719 JAMES A LIVERMORE MD
Individual
Anesthesiology26051 LAHSER RD
SOUTHFIELD, MI 48034
(248) 223-9945
1063528172 LESLIE A MUMAW MD
Individual
Anesthesiology26051 LAHSER RD
SOUTHFIELD, MI 48034
(248) 223-9945
1346356458 MICHAEL BERNARD MD
Individual
Anesthesiology26051 LAHSER RD
SOUTHFIELD, MI 48034
(248) 223-9945

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1568420388, enumerated in the NPI registry as an "organization" on May 02, 2006

The provider is located at 26051 Lahser Rd Southfield, Mi 48034 and the phone number is (248) 223-9925

This medical organization specializes in Clinic/Center with taxonomy code 261QA1903X with a focus in Ambulatory Surgical

The provider might be accepting Accepts: Ambetter from Meridian, Ambetter Health, Blue Care. Please consult your insurance carrier or call the provider to make sure your health plan is currently accepted.

The most common procedures or services performed by this practitioner are: Complete exam of nose and sinuses using an endoscope, Removal of cataract with insertion of prosthetic lens, Removal of nasal air passage under lining tissue, Removal of nasal sinus tissue using an endoscope and Reshaping of nasal cartilage.

The provider's CLIA number is 23D1036250 for a "ambulatory surgery center" facility with a CLIA Certificate of Waiver. This CLIA certificate is issued to perform only waived tests. CLIA defines waived tests as simple tests with a low risk for an incorrect result. Waived tests include certain tests listed in CLIA regulations, tests cleared by the FDA for home use and tests approved by the FDA for waived status and that meet CLIA waiver criteria..

This NPI record was last updated on May 02, 2006. To officially update your NPI information contact the National Plan and Provider Enumeration System (NPPES) at 1-800-465-3203 (NPI Toll-Free) or by email at [email protected].
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