NPIMap

Organization Active NPI

Monterey Peninsula Surgery Center LLC

  • Ambulatory Surgical Clinic/Center
  • Monterey, CA
National Provider Identifier
1104850312
Registry record updated Dec 30, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X
License
070000398 Issued in CA
Legal business name
MONTEREY PENINSULA SURGERY CENTER LLC
Practice address
966 Cass St Ste 150
Monterey, CA 93940-4522
Phone
(831) 372-2169
Fax
(831) 372-6323
NPI assigned
Jul 11, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 30, 2025

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

Authorized official

Name
Ms. Carrie Millsap
Title
Ceo
Phone
(831) 372-2169

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ambulatory Surgical Clinic/Center 261QA1903X 070000398 CA Primary

Addresses

Primary practice location

966 Cass St Ste 150
Monterey, CA 93940-4522

Mailing address

966 Cass St Ste 150
Monterey, CA 93940-4522
Phone (831) 372-2169

Other identifiers 1

IdentifierTypeStateIssuer
SUR01028GMedicaidCA

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20080110000636 CA Part B Supplier - Ambulatory Surgical Center 4587744974 Practice locations: Monterey, CA

Other NPIs with the same Medicare PAC ID 4

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Care Compare: Ambulatory surgical center

Medicare Care Compare
Listed as
Monterey Peninsula Surgery Center LLCCCN 05C0001028
Medicare certification status
ActiveFrom the Provider of Services file

National Provider Directory

National Provider Directory
Tax ID family
Monterey Peninsula Surgery Center LLC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Member of 2

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

Locations

966 Cass St
Monterey, CA 93940
Phone (831) 373-7733

966 Cass St
Ste 210
Monterey, CA 93940
Phone (408) 372-2169

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1152576000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1767052800000",
    "number": "1104850312",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "966 CASS ST STE 150",
            "city": "MONTEREY",
            "state": "CA",
            "postal_code": "939404522",
            "telephone_number": "831-372-2169",
            "fax_number": "831-372-6323"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "966 CASS ST STE 150",
            "city": "MONTEREY",
            "state": "CA",
            "postal_code": "939404522",
            "telephone_number": "831-372-2169",
            "fax_number": "831-372-6323"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MONTEREY PENINSULA SURGERY CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-11",
        "last_updated": "2025-12-30",
        "certification_date": "2025-12-30",
        "status": "A",
        "authorized_official_last_name": "MILLSAP",
        "authorized_official_first_name": "CARRIE",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "831-372-2169",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": "CA",
            "license": "070000398",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "SUR01028G",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Monterey, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 30, 2025; 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.