Renaissance Surgery Center, LLC

Primary specialty

Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X

License

550000544 Issued in CA

Legal business name

RENAISSANCE SURGERY CENTER, LLC

Practice address

2365 E Fir Ave
Fresno, CA 93720-8016

Phone

(559) 797-9100

Fax

(559) 797-9103

NPI assigned

Jan 12, 2007

Organization subpart

No

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

Authorized official

Name

Eric Boon

Title

Officer / Authorized Official

Phone

(480) 567-0269

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Listed as

Renaissance Surgery Center LLCCCN 05C0001702

Medicare certification status

ActiveFrom the Provider of Services file

Listed as

Renaissance Surgery Center LLCCCN 05C0001813

Medicare certification status

ActiveFrom the Provider of Services file

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

CLIA laboratory certificates

Member of 4

Organizations this organization is a member of, according to the National Provider Directory.

• Central California Faculty Medical Group, Inc.

  • Emergency Medicine Physician
  • Fresno, CA
  • NPI 1457603573

  Member Of

  NPD member
• Saint Agnes Medical Center

  • General Acute Care Hospital
  • Fresno, CA
  • NPI 1205845567

  Member Of

  NPD member
• Baylor University Medical Center

  • General Acute Care Hospital
  • Dallas, TX
  • NPI 1447250253

  Member Of

  NPD member
• VHS San Antonio Partners LLC

  • Psychiatric Hospital Unit
  • San Antonio, TX
  • NPI 1487633509

  Member Of

  NPD member

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Ian Todd Johnson, MD

  • Neurological Surgery Physician
  • Fresno, CA
  • NPI 1407936115
  NPD (past)

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

{
    "created_epoch": "1168560000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1733270400000",
    "number": "1013068642",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2365 E FIR AVE",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937208016",
            "telephone_number": "559-797-9100",
            "fax_number": "559-797-9103"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2365 E FIR AVE",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937208016",
            "telephone_number": "559-797-9100",
            "fax_number": "559-797-9103"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RENAISSANCE SURGERY CENTER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-12",
        "last_updated": "2024-12-04",
        "certification_date": "2024-12-04",
        "status": "A",
        "authorized_official_last_name": "BOON",
        "authorized_official_first_name": "ERIC",
        "authorized_official_title_or_position": "OFFICER / AUTHORIZED OFFICIAL",
        "authorized_official_telephone_number": "480-567-0269"
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": "CA",
            "license": "550000544",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://esmd.abilitynetwork.com:8291/gateway/documentsubmission/2_0/NhinService/XDRRequest_Service",
            "affiliation": "Y",
            "endpointDescription": "2.16.840.1.113883.3.667.2",
            "affiliationName": "Ability Network",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "CMS esMD eMDR",
            "address_1": "100 N 6th St Ste 900A",
            "city": "Minneapolis",
            "state": "MN",
            "country_code": "US",
            "postal_code": "554031516",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Rodney C. Remington, M.D.
• Anne Rempel, MD
• Jiale Ren, RDN
• Xiaoshan Ren, PHARMD
• Renaissance Sleep Center, Inc
• Renalite
• Caroline Render-Teixeira, MD
• John Rendig, PT
• Rendoll Concepcion M.D, Inc
• Miriam Lizbeth Rendon Flores

• Ambulatory Surgical Clinic/Center in Fresno, CA
• Providers in Fresno, 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 Dec 4, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• 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.