Premier Surgical Pavilion of la

Primary specialty

Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X

Legal business name

PREMIER SURGICAL PAVILION OF LA

Practice address

11661 San Vicente Blvd
Los Angeles, CA 90049-5103

Phone

(212) 223-0716

NPI assigned

Jul 3, 2019

Organization subpart

No

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

Authorized official

Name

Dr. Michael Eugene Jones, MDNPI 1134297484

Title

Medical Director

Phone

(212) 223-0716

Specialties & licenses 1

Addresses

Other identifiers 1

Electronic endpoints 1

Locations

Practitioners 1

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.

• Michael Jones

  • Plastic Surgery Physician
  • New York, NY
  • NPI 1134297484
  Authorized official Same address or phone

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

{
    "created_epoch": "1562112000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1562112000000",
    "number": "1114589793",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "115 E 39TH ST",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100160943",
            "telephone_number": "212-223-0716"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11661 SAN VICENTE BLVD",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900495103",
            "telephone_number": "212-223-0716"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PREMIER SURGICAL PAVILION OF LA",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-07-03",
        "last_updated": "2019-07-03",
        "status": "A",
        "authorized_official_last_name": "JONES",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "EUGENE",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "212-223-0716",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAL LICENSE",
            "identifier": "C53266",
            "state": "CA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "contact@lexingtonplasticsurgeons.com",
            "affiliation": "N",
            "endpointDescription": "hippa compliant email for patient information",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "direct message",
            "address_1": "11661 San Vicente Blvd",
            "city": "Los Angeles",
            "state": "CA",
            "country_code": "US",
            "postal_code": "900495103",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Premier Management Association
• Premier Marketing Resources Corp (Johnnies Ride, Personal Transportation Services)
• Premier Med Services Inc
• Premier Nephrology Medical Group, Inc.
• Premier Point Medical Group
• Premier Wound Care of Los Angeles
• Premiere Clinical Laboratory,Inc.
• Premiere Dental Care, Inc.
• Premiere Therapy
• Premise Health of California Medical PC (Warner Bros. Discovery Health & Wellness Center at Ivy Station)

• Ambulatory Surgical Clinic/Center in Los Angeles, CA
• Providers in Los Angeles, 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 Jul 3, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.