NPIMap

Organization Active NPI

Glenwood Surgical Center L P

  • Ambulatory Surgical Clinic/Center
  • Riverside, CA
National Provider Identifier
1083670970
Registry record updated Jun 12, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X
Legal business name
GLENWOOD SURGICAL CENTER L P
Practice address
8945 Magnolia Ave Ste 200
Riverside, CA 92503-4436
Phone
(951) 688-7270
Fax
(951) 352-3736
NPI assigned
Apr 21, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 12, 2024

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

Authorized official

Name
Clifton Michael Frazier
Title
Chief Executive Officer
Phone
(951) 688-7270

Specialties & licenses 1

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

Addresses

Primary practice location

8945 Magnolia Ave Ste 200
Riverside, CA 92503-4436

Mailing address

8945 Magnolia Ave
Suite 200
Riverside, CA 92503-4436

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20080326001050 CA Part B Supplier - Ambulatory Surgical Center 5597841874 Practice locations: Riverside, CA

Care Compare: Ambulatory surgical center

Medicare Care Compare
Listed as
Glenwood Surgical Center LPCCN 05C0001082
Medicare certification status
ActiveFrom the Provider of Services file

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 8

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": "1145577600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1718150400000",
    "number": "1083670970",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8945 MAGNOLIA AVE",
            "address_2": "SUITE 200",
            "city": "RIVERSIDE",
            "state": "CA",
            "postal_code": "925034436"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8945 MAGNOLIA AVE STE 200",
            "city": "RIVERSIDE",
            "state": "CA",
            "postal_code": "925034436",
            "telephone_number": "951-688-7270",
            "fax_number": "951-352-3736"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GLENWOOD SURGICAL CENTER L P",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-04-21",
        "last_updated": "2024-06-12",
        "certification_date": "2024-06-12",
        "status": "A",
        "authorized_official_last_name": "FRAZIER",
        "authorized_official_first_name": "CLIFTON",
        "authorized_official_middle_name": "MICHAEL",
        "authorized_official_title_or_position": "CHIEF EXECUTIVE OFFICER",
        "authorized_official_telephone_number": "951-688-7270"
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Riverside, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 12, 2024; 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.