Organization Active NPI

Procedure Center of South Sacramento Inc

  • Ambulatory Surgical Clinic/Center
  • Sacramento, CA
National Provider Identifier
1174597819
Registry record updated Dec 5, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X
License
030000773 Issued in CA
Legal business name
PROCEDURE CENTER OF SOUTH SACRAMENTO INC
Practice address
8120 Timberlake Way
Ste 103
Sacramento, CA 95823-5412
Phone
(916) 423-2124
Fax
(916) 423-2127
NPI assigned
Feb 16, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 5, 2012

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

Authorized official

Name
Dr. Thomas J Imperato, M.D.NPI 1902871684
Title
Medical Director
Phone
(916) 423-2124

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 030000773 CA Primary

Addresses

Primary practice location

8120 Timberlake Way
Ste 103
Sacramento, CA 95823-5412

Mailing address

8120 Timberlake Way
Ste 103
Sacramento, CA 95823-5412
Phone (916) 423-2124

Other identifiers 2

IdentifierTypeStateIssuer
P00106216OtherCARAILROAD MEDICARE
SUR01604FMedicaidCA

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
05D1013433Procedure Center of South Sacramento8120 Timberlake #103, Sacramento, CA 95823Certificate of waiverJun 9, 2027

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

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.

NPI Registry JSON

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

{
    "created_epoch": "1140048000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1354665600000",
    "number": "1174597819",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8120 TIMBERLAKE WAY",
            "address_2": "STE 103",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958235412",
            "telephone_number": "916-423-2124",
            "fax_number": "916-423-2127"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8120 TIMBERLAKE WAY",
            "address_2": "STE 103",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958235412",
            "telephone_number": "916-423-2124",
            "fax_number": "916-423-2127"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROCEDURE CENTER OF SOUTH SACRAMENTO INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-02-16",
        "last_updated": "2012-12-05",
        "status": "A",
        "authorized_official_last_name": "IMPERATO",
        "authorized_official_first_name": "THOMAS",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "916-423-2124",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": "CA",
            "license": "030000773",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00106216",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "SUR01604F",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Sacramento, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 5, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • 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.