Organization Active NPI

Avalon Surgery and Robotic Center, LLC

  • Ambulatory Surgical Clinic/Center
  • Glendale, CA
National Provider Identifier
1194185637
Registry record updated Jul 15, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X
Legal business name
AVALON SURGERY AND ROBOTIC CENTER, LLC
Practice address
435 Arden Ave Suite 520
Glendale, CA 91203
Phone
(818) 696-0091
Fax
(818) 484-2449
NPI assigned
Feb 25, 2016
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 15, 2024

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

Authorized official

Name
Silva Moradi
Title
Ceo
Phone
(818) 696-0091

Specialties & licenses 1

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

Addresses

Primary practice location

435 Arden Ave Suite 520
Glendale, CA 91203

Mailing address

435 Arden Ave Suite 520
Glendale, CA 91203
Phone (818) 696-0091

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20160421002294 CA Part B Supplier - Ambulatory Surgical Center 9234438441 Practice locations: Glendale, CA
O20201026002809 CA Part B Supplier - Independent Clinical Laboratory 9234438441 Practice locations: Glendale, CA

Care Compare: Ambulatory surgical center

Medicare Care Compare
Listed as
Avalon Surgery and Robotic Center LLCCCN 05C0002119
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
05D2284909Avalon Surgery and Robotic Center435 Arden Ave Suite 520, Glendale, CA 91203Certificate of waiverJun 28, 2027

National Provider Directory

National Provider Directory
Tax ID family
Avalon Surgery and Robotic Center LLC3 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.

Locations

435 Arden Ave
Ste 520
Glendale, CA 91203
Phone (818) 247-5440

200 S Louise St
#100
Glendale, CA 91205
Phone (818) 696-0091

NPI Registry JSON

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

{
    "created_epoch": "1456358400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1721001600000",
    "number": "1194185637",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "435 ARDEN AVE SUITE 520",
            "city": "GLENDALE",
            "state": "CA",
            "postal_code": "91203",
            "telephone_number": "818-696-0091",
            "fax_number": "818-484-2449"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "435 ARDEN AVE SUITE 520",
            "city": "GLENDALE",
            "state": "CA",
            "postal_code": "91203",
            "telephone_number": "818-696-0091",
            "fax_number": "818-484-2449"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AVALON SURGERY AND ROBOTIC CENTER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-02-25",
        "last_updated": "2024-07-15",
        "certification_date": "2024-07-15",
        "status": "A",
        "authorized_official_last_name": "MORADI",
        "authorized_official_first_name": "SILVA",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "818-696-0091"
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Glendale, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 15, 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.