Ridgecrest Regional Hospital
Organization Active NPI Ambulatory Surgical Clinic/Center · Ridgecrest, CA
NPI 1164067971 · NPPES record last updated Nov 21, 2023
Key facts
- NPI
- 1164067971
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Ambulatory Surgical Clinic/Center 261QA1903X
- Legal business name
- RIDGECREST REGIONAL HOSPITAL
- Practice address
- 1111 N China Lake Blvd Ste 220
Ridgecrest, CA 93555-3131 - Phone
- (760) 499-3900
- Fax
- (760) 446-2254
- NPI assigned
- Nov 15, 2019
- Organization subpart
- No
Authorized official
- Name
- James A Suver
- Title
- Ceo
- Phone
- (760) 499-3900
Owned or controlled facilities with NPI records 5
Other NPIs with the same Medicare PAC ID 8
Practitioners 169
-
Ihab Edward Beblawi, M.D.
-
Arjun Chandrasekaran, M.D.
-
Udaya Desilva, M.D.
-
Elodi Joy Dielubanza, M.D.
-
Vu Dinh, D.O.
-
Mitchell Geoffrey Goldenberg, MBBS, PHD
-
Mark Harold Kogan, M.D.
-
Andrew McCague, DO, FACOS, FACS
-
Jamal Abdoalah Nabhani, M.D.
-
Dana Pan, MD
-
Lisa Elaine Brand, M.D.
-
Tien-Chun Chen, MD
-
Kiran Fatima Narsinh, M.D.
-
Samir Nayyar, MD
-
Ken Duong Nguyen, M.D.
-
Janine Arbelaez, PSY.D
-
Alan Russell Bowles, LVN
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in CA
All facility ownership & control disclosures 5
| Facility | Type | Role | Since |
|---|---|---|---|
| Ridgecrest Regional Hospital |
Hospital | 5% Or Greater Direct Ownership Interest (100%) | Sep 11, 2012 |
| Ridgecrest Obstetrics Clinic |
Rural health clinic | Operational/Managerial Control (100%) | Sep 17, 2016 |
| RRH Mobile Health Clinic |
Rural health clinic | Operational/Managerial Control (100%) | Sep 29, 2016 |
| Southern Sierra Medical Clinic |
Rural health clinic | Operational/Managerial Control (100%) | Jun 1, 2019 |
| China Lake Community Health Clinic |
Rural health clinic | Operational/Managerial Control (100%) | Jun 1, 2020 |
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20220404002049 | CA | Part B Supplier - Ambulatory Surgical Center | 9739099896 |
Receives reassigned benefits from 19 practitioners Practice locations: Ridgecrest, CA |
National Provider Directory
Locations
540 Perdew Ave
Ste Cd
Ridgecrest, CA 93555
Phone (760) 499-3630
1653 Triangle Dr
#A
Ridgecrest, CA 93555
Phone (760) 499-3617
1111 N China Lake Blvd
#190
Ridgecrest, CA 93555
Phone (760) 499-3855
540 Perdew Ave
Ste C
Ridgecrest, CA 93555
Phone (760) 446-3611
1653 Triangle Dr
#B
Ridgecrest, CA 93555
Phone (760) 499-3617
350 E Ridgecrest Blvd
Ste 107
Ridgecrest, CA 93555
Phone (760) 375-6531
105 E Sydnor Ave
Ste 100204
Ridgecrest, CA 93555
Phone (760) 446-6404
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Surgery Physician |
208600000X | |||
| Ambulatory Surgical Clinic/Center | 261QA1903X | Yes |
Addresses
Primary practice location
1111 N China Lake Blvd Ste 220
Ridgecrest, CA 93555-3131
Mailing address
1081 N China Lake Blvd
Ridgecrest, CA 93555-3130
Phone (760) 499-3900
Other names
- Ridgecrest Regional Hospital Ambulatory Surgery Center
Other providers in Ridgecrest, CA
- Ridgecrest Healthcare, Inc.
- Ridgecrest Medical Supply
- Ridgecrest Medical Transport Corporation
- Ridgecrest Medical Transportation
- Ridgecrest Physical Therapy
- Ridgecrest Regional Hospital
- Ridgecrest Regional Hospital
- Ridgecrest Regional Hospital
- Ridgecrest Regional Hospital
- Ridgecrest Regional Hospital
All providers in Ridgecrest, CA · Ambulatory Surgical Clinic/Center in California
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 21, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- CMS facility enrollments, All Owners and change-of-ownership files: CCNs, owners and managing parties.
- Provider of Services files (CMS): certification status, beds and related CCNs.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.