Back Institute Surgery Center of Beverly Hills

Primary specialty

Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X

Legal business name

BACK INSTITUTE SURGERY CENTER OF BEVERLY HILLS

Practice address

220 S Robertson Blvd
Beverly Hills, CA 90211-2811

Phone

(310) 551-0690

NPI assigned

Jul 2, 2007

Last updated

Feb 26, 2009By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Darren Kim

Title

Administrator

Phone

(310) 551-0690

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1134326119. Details of each certification follow.

• CCN 05C0001844 Ambulatory surgical center · Active · Name & address match · Details

Ambulatory surgical center certification: CCN 05C0001844

Legal name

BACK INSTITUTE SURGERY CENTER OF BEVERLY HILLS

Certification status

Active

Provider type (POS)

Ambulatory surgical center

Participating since

Oct 30, 2007

Last certification

Sep 4, 2014

Ownership / control type

Proprietary

Facility address

220 South Robertson Blvd
Beverly Hills, CA 90211

Practitioners 3

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.

• David Alan Ditsworth, M.D.

  • Surgery Physician
  • Los Angeles, CA
  • NPI 1376685420
  NPD (past)
• Youssef Lalezarian, M.D.

  • Gynecology Physician
  • Los Angeles, CA
  • NPI 1922188259
  NPD (past)
• Brownell Hilliard Payne, MD

  • General Practice Physician
  • Los Angeles, CA
  • NPI 1720156490
  NPD (past)

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

{
    "created_epoch": "1183334400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1235606400000",
    "number": "1134326119",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "920 S ROBERTSON BLVD",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900351612"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "220 S ROBERTSON BLVD",
            "city": "BEVERLY HILLS",
            "state": "CA",
            "postal_code": "902112811",
            "telephone_number": "310-551-0690"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BACK INSTITUTE SURGERY CENTER OF BEVERLY HILLS",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-07-02",
        "last_updated": "2009-02-26",
        "status": "A",
        "authorized_official_last_name": "KIM",
        "authorized_official_first_name": "DARREN",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "310-551-0690"
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Babak Azizzadeh, Inc.
• Babak Eshaghian MD, Inc
• Babak Larian, Inc.
• Reza Babapour, MD
• Daniel Bach, MD
• Back to Balance Rehabilitation and Fitness Inc.
• Bad-Betty LLC
• Amir Ali Badiei, M.D.
• Yong Bae, L.AC, PH.D.
• Bonnie Baehr, AU.D.

• Ambulatory Surgical Clinic/Center in Beverly Hills, CA
• Providers in Beverly Hills, 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 Feb 26, 2009; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.