Organization Active NPI

Central Surgery Center LLC

  • Ambulatory Surgical Clinic/Center
  • Glendale, CA
National Provider Identifier
1104440189
Registry record updated Jun 4, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X
Legal business name
CENTRAL SURGERY CENTER LLC
Practice address
800 S Central Ave Ste 102
Glendale, CA 91204-4370
Phone
(818) 388-0877
NPI assigned
Jun 4, 2020
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 4, 2020

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

Authorized official

Name
Natalie A Plyamm
Title
Administrator
Phone
(818) 388-0877

Specialties & licenses 1

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

Addresses

Primary practice location

800 S Central Ave Ste 102
Glendale, CA 91204-4370

Mailing address

800 S Central Ave Ste 102
Glendale, CA 91204-4370
Phone (818) 388-0877

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20201005000361 CA Part B Supplier - Ambulatory Surgical Center 6507285962 Practice locations: Glendale, CA

National Provider Directory

National Provider Directory

Locations

800 S Central Ave
Ste 102
Glendale, CA 91204
Phone (818) 388-0877

NPI Registry JSON

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

{
    "created_epoch": "1591228800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1591228800000",
    "number": "1104440189",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "800 S CENTRAL AVE STE 102",
            "city": "GLENDALE",
            "state": "CA",
            "postal_code": "912044370",
            "telephone_number": "818-388-0877"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 S CENTRAL AVE STE 102",
            "city": "GLENDALE",
            "state": "CA",
            "postal_code": "912044370",
            "telephone_number": "818-388-0877"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CENTRAL SURGERY CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-06-04",
        "last_updated": "2020-06-04",
        "certification_date": "2020-06-04",
        "status": "A",
        "authorized_official_last_name": "PLYAMM",
        "authorized_official_first_name": "NATALIE",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "818-388-0877"
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Glendale, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 4, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.