Grass Valley Outpatient Surgery Center LP

Primary specialty

Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X

Legal business name

GRASS VALLEY OUTPATIENT SURGERY CENTER LP

Doing business as

Grass Valley Surgery Center

Practice address

408 Sierra College Dr
Grass Valley, CA 95945-5089

Phone

(530) 271-2282

Fax

(530) 271-2287

NPI assigned

Jul 15, 2010

Last updated

Oct 7, 2024By 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

Eric Boon

Title

Officer/Authorized Official

Phone

(480) 567-9026

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Grass Valley Surgery Center Doing business as

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Listed as

Grass Valley Surgery CenterCCN 05C0001757

Medicare certification status

ActiveFrom the Provider of Services file

Member of 5

Organizations this organization is a member of, according to the National Provider Directory.

• CHW Medical Foundation

  dba Mercy Imaging Centers, a Service of CHW Medical Foundation

  • Multi-Specialty Clinic/Center
  • Carmichael, CA
  • NPI 1588696629

  Member Of

  NPD member
• Sierra Nevada Memorial-Miners Hospital

  dba Sierra Nevada Home Care

  • Home Health Agency
  • Grass Valley, CA
  • NPI 1841294782

  Member Of

  NPD member
• Baylor University Medical Center

  • Durable Medical Equipment & Medical Supplies
  • Dallas, TX
  • NPI 1518967231

  Member Of

  NPD member
• Dignity Health

  dba Mercy Gilbert Medical Center

  • General Acute Care Hospital
  • Gilbert, AZ
  • NPI 1992735088

  Member Of

  NPD member
• VHS San Antonio Partners LLC

  dba Baptist Health System

  • Psychiatric Hospital Unit
  • San Antonio, TX
  • NPI 1487633509

  Member Of

  NPD member

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.

• Bruce V Lattyak, M.D.

  • Plastic Surgery Physician
  • Grass Valley, CA
  • NPI 1629245238
  NPD (past)

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

{
    "created_epoch": "1279152000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1728259200000",
    "number": "1184937468",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "408 SIERRA COLLEGE DR",
            "city": "GRASS VALLEY",
            "state": "CA",
            "postal_code": "959455089",
            "telephone_number": "530-271-2282",
            "fax_number": "530-271-2287"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "408 SIERRA COLLEGE DR",
            "city": "GRASS VALLEY",
            "state": "CA",
            "postal_code": "959455089",
            "telephone_number": "530-271-2282",
            "fax_number": "530-271-2287"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GRASS VALLEY OUTPATIENT SURGERY CENTER LP",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-07-15",
        "last_updated": "2024-10-07",
        "certification_date": "2024-10-07",
        "status": "A",
        "authorized_official_last_name": "BOON",
        "authorized_official_first_name": "ERIC",
        "authorized_official_title_or_position": "OFFICER/AUTHORIZED OFFICIAL",
        "authorized_official_telephone_number": "480-567-9026"
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00935009",
            "state": "CA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://esmd.abilitynetwork.com:8291/gateway/documentsubmission/2_0/NhinService/XDRRequest_Service",
            "affiliation": "Y",
            "endpointDescription": "2.16.840.1.113883.3.667.2",
            "affiliationName": "Ability Network",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "CMS esMD eMDR",
            "address_1": "100 N 6th St Ste 900A",
            "city": "Minneapolis",
            "state": "MN",
            "country_code": "US",
            "postal_code": "554031516",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Grass Valley Surgery Center",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Grass Valley Surgery Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Grass Valley Chiropractic
• Grass Valley Extended Care Inc
• Grass Valley Eye Care Optometric, Inc.
• Grass Valley Hematology/Oncology Med GRP
• Grass Valley Hope Medical Group
• Grass Valley Radiation Oncology
• Grass Valley Radiology Medical Group, Inc
• Grass Valley School District
• Grass Valley Surgery Center, LLC
• Dawn Graves

• Ambulatory Surgical Clinic/Center in Grass Valley, CA
• Providers in Grass Valley, 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 Oct 7, 2024; 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.