Inland Empire Minimally Invasive Surgery Institute Inc

Primary specialty

Special HospitalTaxonomy code 284300000X

Legal business name

INLAND EMPIRE MINIMALLY INVASIVE SURGERY INSTITUTE INC

Practice address

1902 Fullerton Ave
Suite 101
Corona, CA 92881-3112

Phone

(310) 728-0494

NPI assigned

Jan 14, 2016

Last updated

Jun 18, 2024By 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. Michael Sedrak, MDNPI 1750464111

Title

Owner

Phone

(310) 728-0494

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1083070494. Details of each certification follow.

• CCN 05C0002162 Ambulatory surgical center · Active · Name & address match · Details

Ambulatory surgical center certification: CCN 05C0002162

Legal name

INLAND EMPIRE MINIMALLY INVASIVE SURGERY INSTITUTE

Certification status

Active

Provider type (POS)

Ambulatory surgical center

Participating since

Oct 20, 2017

Last certification

Dec 10, 2020

Ownership / control type

Proprietary

Facility address

1902 Fullerton Ave Ste 101
Corona, CA 92881

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

CLIA laboratory certificates

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.

• Michael Fayez Sedrak, MD

  • Surgery Physician
  • Corona, CA
  • NPI 1750464111
  NPD (past) Authorized official

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

{
    "created_epoch": "1452729600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1718668800000",
    "number": "1083070494",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1902 FULLERTON AVE",
            "address_2": "SUITE 101",
            "city": "CORONA",
            "state": "CA",
            "postal_code": "928813112",
            "telephone_number": "951-479-8994"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1902 FULLERTON AVE",
            "address_2": "SUITE 101",
            "city": "CORONA",
            "state": "CA",
            "postal_code": "928813112",
            "telephone_number": "310-728-0494"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INLAND EMPIRE MINIMALLY INVASIVE SURGERY INSTITUTE INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-01-14",
        "last_updated": "2024-06-18",
        "certification_date": "2024-06-18",
        "status": "A",
        "authorized_official_last_name": "SEDRAK",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "310-728-0494",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "284300000X",
            "taxonomy_group": "",
            "desc": "Special Hospital",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Nancy Iniguez-Padilla
• Inland Durable Medical Equipment &
• Inland Empire Adult Day Healthcare Center, Inc.
• Inland Empire Imaging
• Inland Empire Integrated Pain Management Center Inc
• Inland Empire Surgical Center LP
• Inland Eye Specialists, a Medical Corporation (In Focus Ophthalmic Plastic Surgery)
• Inland Heart Doctors Medical Group
• Inland Lung Institute Professional Corporation
• Inland Psychiatric Medical Group Inc

• Special Hospital in Corona, CA
• Providers in Corona, CA by specialty
• Special Hospital in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 18, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
• 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.