Sierra Ambulatory Surgery Center

Primary specialty

Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X

License

550000155 Issued in CA

Legal business name

SIERRA AMBULATORY SURGERY CENTER

Practice address

400 Sierra College Drive
Suite B
Grass Valley, CA 95945-5089

Phone

(530) 272-3428

Fax

(530) 272-3429

NPI assigned

Jun 16, 2006

Last updated

Dec 27, 2012By 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

Dr. John Edward Hagele, M.D.NPI 1134200629

Title

President

Phone

(530) 272-3411

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Listed as

Sierra Ambulatory Surgery CenterCCN 05C0001760

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 2

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.

• John Edward Hagele, M.D.

  • Ophthalmology Physician
  • Grass Valley, CA
  • NPI 1134200629
  Authorized official Same address or phone
• Gregory J Porter, M.D.

  • Anesthesiology Physician
  • Grass Valley, CA
  • NPI 1790741262
  NPD (past)

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

{
    "created_epoch": "1150416000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1356566400000",
    "number": "1043254063",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 SIERRA COLLEGE DRIVE",
            "address_2": "SUITE B",
            "city": "GRASS VALLEY",
            "state": "CA",
            "postal_code": "959455089",
            "telephone_number": "530-272-3428",
            "fax_number": "530-272-3429"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 SIERRA COLLEGE DRIVE",
            "address_2": "SUITE B",
            "city": "GRASS VALLEY",
            "state": "CA",
            "postal_code": "959455089",
            "telephone_number": "530-272-3428",
            "fax_number": "530-272-3429"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SIERRA AMBULATORY SURGERY CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-16",
        "last_updated": "2012-12-27",
        "status": "A",
        "authorized_official_last_name": "HAGELE",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "EDWARD",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "530-272-3411",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": "CA",
            "license": "550000155",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE NUMBER",
            "identifier": "550000155",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Wanda G Shiotsuka, OT
• Alyssa Shipley
• Nathan Michael Shook
• Crystal Short
• Manpreet Singh Sidhu
• Sierra Derm Inc.
• Sierra Endoscopy Center, LLC
• Sierra Family Therapy Centers, Inc.
• Sierra Forever Families
• Sierra Forever Families

• Ambulatory Surgical Clinic/Center in Grass Valley, CA
• Providers in Grass Valley, 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 27, 2012; 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.