Cosmetic Surgery Center of Santa Monica a Medical Corp

Primary specialty

Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X

License

S051566 Issued in CA

Legal business name

COSMETIC SURGERY CENTER OF SANTA MONICA A MEDICAL CORP

Practice address

1260 15TH St
Suite 1401
Santa Monica, CA 90404

Phone

(310) 434-2495

Fax

(310) 434-2497

NPI assigned

Aug 30, 2006

Organization subpart

No

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

Authorized official

Name

Ralph A Massey, MDNPI 1891700332

Title

Medical Director

Phone

(310) 434-2495

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Listed as

Cosmetic Surgery Center of Santa MonicaCCN 05C0002275

Medicare certification status

ActiveFrom the Provider of Services file

Listed as

Cosmetic Surgery Center of Santa MonicaCCN 05C0001566

Medicare certification status

Terminated Involuntary: failure to meet health/safety requirements, May 27, 2016From the Provider of Services file

Locations

Practitioners 1

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

• Ralph A Massey, MD

  • MOHS-Micrographic Surgery Physician
  • Santa Monica, CA
  • NPI 1891700332
  NPD Authorized official

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

{
    "created_epoch": "1156896000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1438732800000",
    "number": "1033229323",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1260 15TH ST",
            "address_2": "SUITE 1401",
            "city": "SANTA MONICA",
            "state": "CA",
            "postal_code": "90404",
            "telephone_number": "310-434-2495",
            "fax_number": "310-434-2497"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1260 15TH ST",
            "address_2": "SUITE 1401",
            "city": "SANTA MONICA",
            "state": "CA",
            "postal_code": "90404",
            "telephone_number": "310-434-2495",
            "fax_number": "310-434-2497"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COSMETIC SURGERY CENTER OF SANTA MONICA A MEDICAL CORP",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-30",
        "last_updated": "2015-08-05",
        "status": "A",
        "authorized_official_last_name": "MASSEY",
        "authorized_official_first_name": "RALPH",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "310-434-2495",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": "CA",
            "license": "S051566",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Michelle Cortrite
• Elise Corvo, LMFT
• Joshua Corwin
• Valeska Cosci, L.C.S.W
• Grace Suh Coscia, L.AC.
• Jonathan Patrick Coss, MD
• Sofia Costa, PT, DPT
• Michael A Costine, PA-C
• Edward S Cotner, MD
• Megan Coulter, LCSW

• Ambulatory Surgical Clinic/Center in Santa Monica, CA
• Providers in Santa Monica, 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 Aug 5, 2015; 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.