Organization Active NPI

Hospital Drive Surgery Center, LLC

  • Ambulatory Surgical Clinic/Center
  • Mountain View, CA
National Provider Identifier
1043426950
Registry record updated Aug 6, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X
Legal business name
HOSPITAL DRIVE SURGERY CENTER, LLC
Practice address
2500 Hospital Dr
BLDG. 9, Ste. B
Mountain View, CA 94040-4106
Phone
(650) 254-1200
NPI assigned
May 15, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 6, 2008

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

Authorized official

Name
Dr. Joshua Korman, M.D.NPI 1780723429
Title
Owner
Phone
(650) 254-1200

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

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

Addresses

Primary practice location

2500 Hospital Dr
BLDG. 9, Ste. B
Mountain View, CA 94040-4106

Mailing address

11999 San Vicente Blvd
Ste. 440
Los Angeles, CA 90049-5131
Phone (310) 471-5852

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20050713000168 CA Part B Supplier - Ambulatory Surgical Center 6406882273 Practice locations: Mountain View, CA

Ambulatory surgical center certification: CCN 05C0001549

Name & address match This certification has no NPI in the Medicare enrollment files. CMS publishes enrollment files for six facility types only, so it was connected to this NPI by matching the name and address CMS publishes for it.

Legal name
HOSPITAL DRIVE SURGERY CENTER
Certification status
Active
Provider type (POS)
Ambulatory surgical center
Participating since
May 7, 2002
Last certification
Dec 14, 2020
Ownership / control type
Proprietary
Facility address
2500 Hospital Drive, BLDG 9B
Mountain View, CA 94040

Laboratory certificates & supplier records

Derived by NPIMap

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

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
05D1086627Hospital Drive Surgery Center2500 Hospital Drive #9B, Mountain View, CA 94040Certificate of waiverJul 15, 2028

National Provider Directory

National Provider Directory

Locations

2500 Hospital Dr
Ste 9B
Mountain View, CA 94040
Phone (650) 254-0888

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1179187200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1217980800000",
    "number": "1043426950",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11999 SAN VICENTE BLVD",
            "address_2": "STE. 440",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900495131",
            "telephone_number": "310-471-5852",
            "fax_number": "310-471-3958"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2500 HOSPITAL DR",
            "address_2": "BLDG. 9, STE. B",
            "city": "MOUNTAIN VIEW",
            "state": "CA",
            "postal_code": "940404106",
            "telephone_number": "650-254-1200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HOSPITAL DRIVE SURGERY CENTER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-15",
        "last_updated": "2008-08-06",
        "status": "A",
        "authorized_official_last_name": "KORMAN",
        "authorized_official_first_name": "JOSHUA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "650-254-1200",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mountain View, CA

Sources for this page

Verify at the official NPI Registry.