NPIMap

Organization Active NPI

Congress Medical Surgery Center LLC

  • Ambulatory Surgical Clinic/Center
  • Pasadena, CA
National Provider Identifier
1104087089
Registry record updated Oct 20, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X
License
G81716 Issued in CA
Legal business name
CONGRESS MEDICAL SURGERY CENTER LLC
Practice address
800 S Raymond Ave
Pasadena, CA 91105
Phone
(626) 795-8051
Fax
(626) 795-0356
NPI assigned
Jun 23, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 20, 2010

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

Authorized official

Name
Dr. Michael J Fraipont, MDNPI 1164418893
Title
Medical Director
Phone
(626) 795-8051

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 G81716 CA Primary

Addresses

Primary practice location

800 S Raymond Ave
Pasadena, CA 91105

Mailing address

PO Box 90730
Pasadena, CA 91109-0730
Phone (626) 795-8051

Other identifiers 1

IdentifierTypeStateIssuer
ZZZH1905DOtherCABLUE SHIELD

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20081204000115 CA Part B Supplier - Ambulatory Surgical Center 4587725916 Practice locations: Pasadena, CA

Care Compare: Ambulatory surgical center

Medicare Care Compare
Listed as
Congress Medical Surgery Center LLCCCN 05C0001892
Medicare certification status
ActiveFrom the Provider of Services file

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
05D1087394Congress Medical Surgery Center, LLC800 S Raymond Ave, Pasadena, CA 91105Certificate of waiverJul 31, 2026

National Provider Directory

National Provider Directory

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

Locations

800 S Raymond Ave
Fl 1
Pasadena, CA 91105

80 S Raymond Ave
#O
Pasadena, CA 91105

Practitioners & affiliated clinicians

Practitioners 20

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

View all 20

NPI Registry JSON

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

{
    "created_epoch": "1214179200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1287532800000",
    "number": "1104087089",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 90730",
            "city": "PASADENA",
            "state": "CA",
            "postal_code": "911090730",
            "telephone_number": "626-795-8051",
            "fax_number": "626-795-7374"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 S RAYMOND AVE",
            "city": "PASADENA",
            "state": "CA",
            "postal_code": "91105",
            "telephone_number": "626-795-8051",
            "fax_number": "626-795-0356"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CONGRESS MEDICAL SURGERY CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-06-23",
        "last_updated": "2010-10-20",
        "status": "A",
        "authorized_official_last_name": "FRAIPONT",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "626-795-8051",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": "CA",
            "license": "G81716",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD",
            "identifier": "ZZZH1905D",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Pasadena, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 20, 2010; 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.