NPIMap

Organization Active NPI

Embassy Surgery Center, LLC

  • Ambulatory Surgical Clinic/Center
  • Lancaster, CA
National Provider Identifier
1174063788
Registry record updated Mar 1, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X
Legal business name
EMBASSY SURGERY CENTER, LLC
Practice address
42135 10TH St W
Suite 325
Lancaster, CA 93534-7095
Phone
(661) 726-5005
Fax
(661) 579-2444
NPI assigned
Mar 1, 2017
Last updated
Mar 1, 2017By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 1, 2017

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

Authorized official

Name
Dr. Thomas S Nasser, DONPI 1073594636
Title
Manager
Phone
(661) 726-5005

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

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

Addresses

Primary practice location

42135 10TH St W
Suite 325
Lancaster, CA 93534-7095

Mailing address

42135 10TH St W
Suite 325
Lancaster, CA 93534-7095
Phone (661) 726-5005

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20170929001425 CA Part B Supplier - Ambulatory Surgical Center 8628343787 Receives reassigned benefits from 7 practitioners
Practice locations: Lancaster, CA

Care Compare: Ambulatory surgical center

Medicare Care Compare
Listed as
Embassy Surgery CenterCCN 05C0002228
Medicare certification status
ActiveFrom the Provider of Services file

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
05D2165367Embassy Surgery Center LLC42135 10TH Street Suite 325, Lancaster, CA 93534Certificate of waiverApr 24, 2027

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 11

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.

NPI Registry JSON

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

{
    "created_epoch": "1488326400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1488326400000",
    "number": "1174063788",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "42135 10TH ST W",
            "address_2": "SUITE 325",
            "city": "LANCASTER",
            "state": "CA",
            "postal_code": "935347095",
            "telephone_number": "661-726-5005",
            "fax_number": "661-579-2444"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "42135 10TH ST W",
            "address_2": "SUITE 325",
            "city": "LANCASTER",
            "state": "CA",
            "postal_code": "935347095",
            "telephone_number": "661-726-5005",
            "fax_number": "661-579-2444"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EMBASSY SURGERY CENTER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-03-01",
        "last_updated": "2017-03-01",
        "status": "A",
        "authorized_official_last_name": "NASSER",
        "authorized_official_first_name": "THOMAS",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "661-726-5005",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lancaster, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 1, 2017; 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.