Organization Active NPI

Sunset Surgical Centre LLC

  • Ambulatory Surgical Clinic/Center
  • Portland, OR
National Provider Identifier
1053688036
Registry record updated Nov 19, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X
License
60011591 Issued in OR
Legal business name
SUNSET SURGICAL CENTRE LLC
Practice address
9555 SW Barnes Rd
Suite 275
Portland, OR 97225-6663
Phone
(503) 297-8555
NPI assigned
Nov 19, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 19, 2011

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

Authorized official

Name
Dr. Kim CHI Vu, MDNPI 1770650194
Title
Sole Member
Phone
(509) 297-8555

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 60011591 OR Primary

Addresses

Primary practice location

9555 SW Barnes Rd
Suite 275
Portland, OR 97225-6663

Mailing address

15390 NW Cornell Rd
Beaverton, OR 97006
Phone (503) 297-8555

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20120801000880 OR Part B Supplier - Ambulatory Surgical Center 3971759291 Practice locations: Beaverton, OR

Care Compare: Ambulatory surgical center

Medicare Care Compare
Listed as
Sunset Surgical Centre LLCCCN 38C0001104
Medicare certification status
ActiveFrom the Provider of Services file

National Provider Directory

National Provider Directory

Locations

15390 NW Cornell Rd
Beaverton, OR 97006

9555 SW Barnes Rd
Ste 275
Portland, OR 97225
Phone (503) 297-8555

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": "1321660800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1321660800000",
    "number": "1053688036",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15390 NW CORNELL RD",
            "city": "BEAVERTON",
            "state": "OR",
            "postal_code": "97006",
            "telephone_number": "503-297-8555"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9555 SW BARNES RD",
            "address_2": "SUITE 275",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972256663",
            "telephone_number": "503-297-8555"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUNSET SURGICAL CENTRE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-11-19",
        "last_updated": "2011-11-19",
        "status": "A",
        "authorized_official_last_name": "VU",
        "authorized_official_first_name": "KIM CHI",
        "authorized_official_title_or_position": "SOLE MEMBER",
        "authorized_official_telephone_number": "509-297-8555",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": "OR",
            "license": "60011591",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Portland, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 19, 2011; 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.