MEDICARE: CLIFTON PARK ASC, LLC DBA ORTHONY SURGICAL SUITES AT SARATOGA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QA1903X	Ambulatory Surgical Clinic/Center

General Provider Information

NPI Number	:	1497682199
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CLIFTON PARK ASC, LLC DBA ORTHONY SURGICAL SUITES AT SARATOGA

Provider Business Mailing Address
First Line	:	612 MAPLE AVENUE
Second Line	:	SUITE 260
City	:	SARATOGA SPRINGS
State	:	NY
Zip	:	12866
Country	:	US
Telephone Number	:	518-489-2663
Fax Number	:

Provider Business Practice Location Address
First Line	:	612 MAPLE AVENUE
Second Line	:	SUITE 260
City	:	SARATOGA SPRINGS
State	:	NY
Zip	:	12866
Country	:	US
Telephone Number	:	518-489-2663
Fax Number	:

Authorized Official
Title or Position	:	RCM
Name	:	LISA O'CONNELL
Credential	:
Telephone Number	:	518-489-2663

Provider Enumeration Date	:	05/06/2026
Last Update Date	:	05/21/2026

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