NPIMap

Organization Active NPI

Specialty Care and Surgery Center

  • Ambulatory Surgical Clinic/Center
  • Kelseyville, CA
National Provider Identifier
1184844607
Registry record updated Mar 18, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X
Legal business name
SPECIALTY CARE AND SURGERY CENTER
Practice address
5685 Main St
Kelseyville, CA 95451-8945
Phone
(707) 279-8733
Fax
(707) 279-8731
NPI assigned
Apr 26, 2007
Last updated
Mar 18, 2015By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 18, 2015

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

Authorized official

Name
Paula R Dhanda, MDNPI 1316972425
Title
Owner/Physician
Phone
(707) 279-8733

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

5685 Main St
Kelseyville, CA 95451-8945

Mailing address

5685 Main St
Kelseyville, CA 95451-8945
Phone (707) 279-8733

Medicare participation

Medicare enrollment files
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 1184844607. Details of each certification follow.

Ambulatory surgical center certification: CCN 05C0001834

Name & address match This certification has no NPI in the Medicare enrollment files. CMS publishes enrollment files for six facility types only, so it was connected to this NPI by matching the name and address CMS publishes for it.

Legal name
SPECIALTY CARE AND SURGERY CENTER
Certification status
Active
Provider type (POS)
Ambulatory surgical center
Participating since
Jan 8, 2008
Last certification
Dec 2, 2016
Ownership / control type
Proprietary
Facility address
5685 Main Street
Kelseyville, CA 95451

National Provider Directory

National Provider Directory
Tax ID family
Specialty Care and Surgery Center3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 2

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": "1177545600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1426636800000",
    "number": "1184844607",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5685 MAIN ST",
            "city": "KELSEYVILLE",
            "state": "CA",
            "postal_code": "954518945",
            "telephone_number": "707-279-8733",
            "fax_number": "707-279-8731"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5685 MAIN ST",
            "city": "KELSEYVILLE",
            "state": "CA",
            "postal_code": "954518945",
            "telephone_number": "707-279-8733",
            "fax_number": "707-279-8731"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SPECIALTY CARE AND SURGERY CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-26",
        "last_updated": "2015-03-18",
        "status": "A",
        "authorized_official_last_name": "DHANDA",
        "authorized_official_first_name": "PAULA",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "OWNER/PHYSICIAN",
        "authorized_official_telephone_number": "707-279-8733",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kelseyville, CA

Sources for this page

Verify at the official NPI Registry.