Foothill Surgical Institute, LLC

Primary specialty

Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X

Legal business name

FOOTHILL SURGICAL INSTITUTE, LLC

Practice address

29300 Portola Pkwy
Suite a
Lake Forest, CA 92630-8718

Phone

(949) 367-1006

NPI assigned

Dec 7, 2006

Organization subpart

No

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

Authorized official

Name

Nazli Arefkia

Title

Ceo

Phone

(949) 510-0951

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Ambulatory surgical center certification: CCN 55C0001170

Legal name

Foothill Surgical Institute, LLC

Certification status

Active

Provider type (POS)

Ambulatory surgical center

Participating since

Mar 18, 2024

Last certification

Feb 12, 2024

Facility address

29300 Portola Pkwy
Lake Forest, CA 92630

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.

• Leslie Henry Atterbury III, M.D.

  • Anesthesiology Physician
  • Gig Harbor, WA
  • NPI 1437360328
  NPD (past)

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

{
    "created_epoch": "1165449600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1694649600000",
    "number": "1104985910",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "29300 PORTOLA PKWY STE A",
            "city": "LAKE FOREST",
            "state": "CA",
            "postal_code": "926308741",
            "telephone_number": "949-367-1006"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "29300 PORTOLA PKWY",
            "address_2": "SUITE A",
            "city": "LAKE FOREST",
            "state": "CA",
            "postal_code": "926308718",
            "telephone_number": "949-367-1006"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FOOTHILL SURGICAL INSTITUTE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-07",
        "last_updated": "2023-09-14",
        "certification_date": "2023-09-14",
        "status": "A",
        "authorized_official_last_name": "AREFKIA",
        "authorized_official_first_name": "NAZLI",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "949-510-0951"
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Flourish Speech Therapy Inc.
• Anthony Ernest Follico, DDS
• Jasmine Fonseca Ruiz
• Jessica A Fonseca
• Foothill Gateway Surgery Center LLC
• Carol Ann Ford Shintani, R.N.
• Forest Massage
• Rosalie Aguilar Forestier
• Lauren Forrest
• Jeffrey Lynn Foster

• Ambulatory Surgical Clinic/Center in Lake Forest, CA
• Providers in Lake Forest, CA by specialty
• Ambulatory Surgical Clinic/Center in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 14, 2023; 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.