Type 2 · Organization ✓ Active NPI ✓ Valid NPI checksum

West Lakes Surgery Center LLC

Q: What is the NPI number for West Lakes Surgery Center LLC?

The NPI for West Lakes Surgery Center LLC is 1104933696, a Type 2 (organization) record in the CMS NPPES registry.

Ambulatory Surgical Clinic/Center in Clive, IA · enumerated 2006 · authorized official Teri Formanek, President.

Data current as of Jul 13, 2026 · sourced from CMS NPPES

National Provider Identifier

1104933696

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Registry record

Entity type Organization (Type 2)

Legal business name West Lakes Surgery Center LLC

Practice address 12499 University Ave, Suite 100, Clive, IA, 50325

Phone (515) 974-5050

Enumeration date Aug 23, 2006

Last updated in NPPES Jun 4, 2020

Taxonomy & classification

261QA1903X Ambulatory Surgical Clinic/Center Ambulatory Health Care Facilities · License NA Primary

Authorized official

Name Teri Formanek

Title President

Phone (515) 327-1555

Other identifiers

Identifier	Type	State	Issuer
0610352	Medicaid	IA	-
61026	Other	IA	FEDERAL EMPLOYEES HEALTH
F252394	Other	IA	CARPENTERS DISTRICT COUN
F252394	Other	IA	CIGNA
61026	Other	IA	WELLMARK BCBS
F252394	Other	IA	MIDLANDS AETNA
61026	Other	IA	WELLMARK HEALTH PLANS IA

What is an NPI number?

A National Provider Identifier (NPI) is a unique 10-digit number that CMS assigns to every U.S. healthcare provider and organization under HIPAA. Type 1 NPIs identify individual providers; Type 2 NPIs identify organizations. The NPI appears on insurance claims, prescriptions, and credentialing paperwork, and never changes, even if the provider moves or changes specialty.

Read the full guide → Validate an NPI →

Frequently asked questions

What is the NPI number for West Lakes Surgery Center LLC?

The NPI for West Lakes Surgery Center LLC is 1104933696, a Type 2 (organization) record in the CMS NPPES registry.

Who is the authorized official for West Lakes Surgery Center LLC?

NPPES lists Teri Formanek (President) as the authorized official for this organization.

Providers at this address

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Source: CMS NPPES (public data). Snapshot 2026-07-13. Provider record last updated 2020-06-04.