HIPAA Patient Privacy Notice

Effective Date: 7/10/2025

At SurgiCore Ambulatory Surgery Center (“SurgiCore”, “we”, “our”), we are committed to protecting the privacy and confidentiality of your health information. This notice explains how we may use and share your protected health information (PHI), and your rights under the Health Insurance Portability and Accountability Act of 1996 (HIPAA) and other applicable laws.

1. Our Responsibilities

We are required by law to:

  • Maintain the privacy of your protected health information (PHI)
  • Provide you with this Notice of our legal duties and privacy practices
  • Abide by the terms of this Notice currently in effect
  • Notify you in the event of a breach involving your unsecured health information
2. How We May Use and Disclose Your Health Information

We may use and disclose your health information without your written authorization for the following purposes:

  • Treatment: To provide and coordinate your medical care among providers
  • Payment: To bill and collect payment for the services we provide
  • Healthcare Operations: For internal management, quality assessment, training, and administrative purposes
  • As Required by Law: For public health reporting, law enforcement, judicial proceedings, and other legal obligations
  • To Prevent Serious Threats to Health or Safety:
  • Business Associates: To vendors who help us operate and are contractually obligated to protect your information
3. Uses and Disclosures Requiring Your Authorization

We will obtain your written authorization for:

  • Most uses and disclosures of psychotherapy notes
  • Uses and disclosures for marketing purposes
  • Sale of your health information
  • Any other use or disclosure not described in this Notice

You may revoke your authorization at any time in writing.

4. Your Rights

You have the right to:

  • Access your medical records and request a copy
  • Request corrections to your health information
  • Request restrictions on certain uses or disclosures
  • Request confidential communications, such as at a specific address or phone number
  • Receive an accounting of disclosures we have made of your health information
  • Receive a paper copy of this Notice, even if you agreed to receive it electronically

To exercise any of these rights, please contact us at the information below.

5. Changes to This Notice

We reserve the right to change the terms of this Notice at any time. The updated Notice will be posted on our website and available upon request.

6. Contact Information

If you have questions about this Notice or wish to file a complaint, please contact:

HIPAA Privacy Officer

5. Contact Us

Market Street 444, Saddle Brook, NJ 07663
Newark Avenue 550, Jersey City, NJ 07306
5th Avenue 1049, New York, NY 10028
East 47th Street 305, New York, NY 10017
Broadway 680, Paterson, NJ 07514
Franklin Lane 50, Manalapan Township, NJ 07726
Nostrand Avenue 3632, Brooklyn, NY 11229
North Kinderkamack Road 133, Montvale, NJ 07645
Webster Avenue 3170, Bronx, NY 10467
Francis Lewis Boulevard 45-64, Bayside, NY 11358
Rockaway Beach Boulevard 105-20, Rockaway Park, NY 11694