Organization Active NPI

Advanced Surgery Institute, LLC

  • Ambulatory Surgical Clinic/Center
  • Santa Rosa, CA
National Provider Identifier
1063646594
Registry record updated May 12, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X
Legal business name
ADVANCED SURGERY INSTITUTE, LLC
Practice address
1739 4TH St
Santa Rosa, CA 95404-3601
Phone
(707) 396-0138
Fax
(707) 538-8299
NPI assigned
May 12, 2009
Last updated
May 12, 2009By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 12, 2009

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

Authorized official

Name
Mr. Jeff Simmons
Title
Board Member
Phone
(707) 538-8299

Specialties & licenses 1

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

Addresses

Primary practice location

1739 4TH St
Santa Rosa, CA 95404-3601

Mailing address

1739 4TH St
Santa Rosa, CA 95404-3601
Phone (707) 396-0138

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1242086400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1242086400000",
    "number": "1063646594",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1739 4TH ST",
            "city": "SANTA ROSA",
            "state": "CA",
            "postal_code": "954043601",
            "telephone_number": "707-396-0138",
            "fax_number": "707-538-8299"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1739 4TH ST",
            "city": "SANTA ROSA",
            "state": "CA",
            "postal_code": "954043601",
            "telephone_number": "707-396-0138",
            "fax_number": "707-538-8299"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ADVANCED SURGERY INSTITUTE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-05-12",
        "last_updated": "2009-05-12",
        "status": "A",
        "authorized_official_last_name": "SIMMONS",
        "authorized_official_first_name": "JEFF",
        "authorized_official_title_or_position": "BOARD MEMBER",
        "authorized_official_telephone_number": "707-538-8299",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": "CA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Santa Rosa, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 12, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.