Tracy Surgery Center, LLC

Primary specialty

Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X

Legal business name

TRACY SURGERY CENTER, LLC

Practice address

2160 W Grant Line Rd
Suite 120
Tracy, CA 95377-7330

Phone

(209) 836-5680

NPI assigned

Oct 1, 2007

Last updated

Mar 6, 2023By 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

Jennifer Boyd Baldock

Title

Officer and Authorized Official

Phone

(615) 234-5954

Specialties & licenses 1

Addresses

Other names 1

• Tracy Surgery Center, LLC Other name

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Listed as

Tracy Surgery CenterCCN 05C0001859

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

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Gregory Horner, M.D.

  • Orthopaedic Hand Surgery Physician
  • Pleasanton, CA
  • NPI 1295730331
  NPD (past)

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

{
    "created_epoch": "1191196800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1678060800000",
    "number": "1013104389",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2160 W GRANT LINE RD",
            "address_2": "SUITE 120",
            "city": "TRACY",
            "state": "CA",
            "postal_code": "953777330"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2160 W GRANT LINE RD",
            "address_2": "SUITE 120",
            "city": "TRACY",
            "state": "CA",
            "postal_code": "953777330",
            "telephone_number": "209-836-5680"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TRACY SURGERY CENTER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-10-01",
        "last_updated": "2023-03-06",
        "certification_date": "2023-03-06",
        "status": "A",
        "authorized_official_last_name": "BALDOCK",
        "authorized_official_first_name": "JENNIFER",
        "authorized_official_middle_name": "BOYD",
        "authorized_official_title_or_position": "OFFICER AND AUTHORIZED OFFICIAL",
        "authorized_official_telephone_number": "615-234-5954"
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Tracy Surgery Center, LLC",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "Tracy Surgery Center, LLC",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Tracy Learning Center
• Tracy Optometry Group, Inc
• Tracy Orchard Dental Care
• Tracy Orthopedics and Sports Medical Center
• Tracy Outpatient Surgery Center
• Tracy Unified School District
• Tracy Urgent Care, Inc
• Melanie Trader
• Diana Tran, PA-C
• Vincent Tran, PHARM.D.

• Ambulatory Surgical Clinic/Center in Tracy, CA
• Providers in Tracy, 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 Mar 6, 2023; 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.