Roxbury Clinic and Surgery Center Inc

Primary specialty

Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X

Legal business name

ROXBURY CLINIC AND SURGERY CENTER INC

Practice address

465 N Roxbury Dr
Suite 1001
Beverly Hills, CA 90210-4206

Phone

(310) 248-6250

Fax

(310) 248-6258

NPI assigned

Sep 12, 2007

Last updated

Jun 9, 2009By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mrs. Chona Moore, R.N.

Title

Director of Nursing

Phone

(310) 248-6250

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1003001967. Details of each certification follow.

• CCN 05C0001658 Ambulatory surgical center · Active · Name & address match · Details

Ambulatory surgical center certification: CCN 05C0001658

Legal name

THE ROXBURY CLINIC AND SURGERY CENTER

Certification status

Active

Provider type (POS)

Ambulatory surgical center

Participating since

Apr 23, 2004

Last certification

Dec 4, 2018

Ownership / control type

Proprietary

Facility address

465 North Roxbury Drive, Ste 1001
Beverly Hills, CA 90210

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1189555200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1244505600000",
    "number": "1003001967",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "465 N ROXBURY DR",
            "address_2": "SUITE 1001",
            "city": "BEVERLY HILLS",
            "state": "CA",
            "postal_code": "902104206",
            "telephone_number": "310-248-6250",
            "fax_number": "310-248-6258"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "465 N ROXBURY DR",
            "address_2": "SUITE 1001",
            "city": "BEVERLY HILLS",
            "state": "CA",
            "postal_code": "902104206",
            "telephone_number": "310-248-6250",
            "fax_number": "310-248-6258"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ROXBURY CLINIC AND SURGERY CENTER INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-09-12",
        "last_updated": "2009-06-09",
        "status": "A",
        "authorized_official_last_name": "MOORE",
        "authorized_official_first_name": "CHONA",
        "authorized_official_title_or_position": "DIRECTOR OF NURSING",
        "authorized_official_telephone_number": "310-248-6250",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "R.N."
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mikhail Yakov Rovensky
• Rox Beverly Hills Surgery Center LLC
• Rox Physician Medical Group PC
• Roxbury Anesthesia Group, Inc.
• Roxbury Beverly Hills Surgical Medical Center, Inc
• Roxbury Dermatology and Multispecialty Practice Inc
• Roxbury Dr Outpatient Surg Ctr
• Roxbury Healthcare Group Inc
• Roxbury Institute Surgical Center
• Roxbury Pharmacy, Inc. (Encore Pharmacy)

• Ambulatory Surgical Clinic/Center in Beverly Hills, CA
• Providers in Beverly Hills, CA by specialty
• Ambulatory Surgical Clinic/Center in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 9, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.