NPIMap

Organization Active NPI

Surgicare of la Veta LTD

  • Ambulatory Surgical Clinic/Center
  • Orange, CA
National Provider Identifier
1033177373
Registry record updated Jun 7, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X
Legal business name
SURGICARE OF LA VETA LTD
Practice address
681 S Parker St
Suite 150
Orange, CA 92868-4719
Phone
(714) 744-0900
NPI assigned
May 3, 2006
Last updated
Jun 7, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 7, 2024

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

Authorized official

Name
Jasmine Mossanenenzadeh
Title
Ceo
Phone
(949) 278-0853

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ambulatory Surgical Clinic/Center 261QA1903X NU Primary

Addresses

Primary practice location

681 S Parker St
Suite 150
Orange, CA 92868-4719

Mailing address

681 S Parker St
Suite 150
Orange, CA 92868-4719
Phone (714) 744-0900

Other names 1

  • LaVeta Surgery Center Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20081114000756 CA Part B Supplier - Ambulatory Surgical Center 6204858996 Practice locations: Orange, CA

Other NPIs with the same Medicare PAC ID 2

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Care Compare: Ambulatory surgical center

Medicare Care Compare
Listed as
La Veta Surgical CenterCCN 05C0001178
Medicare certification status
ActiveFrom the Provider of Services file

National Provider Directory

National Provider Directory
Tax ID family
Barranca Surgery Center3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

Member of 1

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

NPI Registry JSON

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

{
    "created_epoch": "1146614400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1717718400000",
    "number": "1033177373",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "681 S PARKER ST",
            "address_2": "SUITE 150",
            "city": "ORANGE",
            "state": "CA",
            "postal_code": "928684719",
            "telephone_number": "714-744-0900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "681 S PARKER ST",
            "address_2": "SUITE 150",
            "city": "ORANGE",
            "state": "CA",
            "postal_code": "928684719",
            "telephone_number": "714-744-0900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SURGICARE OF LA VETA LTD",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-03",
        "last_updated": "2024-06-07",
        "certification_date": "2024-06-07",
        "status": "A",
        "authorized_official_last_name": "MOSSANENENZADEH",
        "authorized_official_first_name": "JASMINE",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "949-278-0853"
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "LaVeta Surgery Center",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Orange, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 7, 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.