NPIMap

Organization Active NPI

Advanced Interventional Surgical Center

  • Interventional Cardiology Physician
  • Fremont, CA
National Provider Identifier
1215452297
Registry record updated Nov 15, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Interventional Cardiology PhysicianTaxonomy code 207RI0011X
Legal business name
ADVANCED INTERVENTIONAL SURGICAL CENTER
Practice address
3077 Stevenson Blvd.
Fremont, CA 94538-2316
Phone
(510) 714-1879
Fax
(510) 796-2215
NPI assigned
Aug 10, 2017
Last updated
Nov 15, 2018By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 15, 2018

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

Authorized official

Name
Ashit Jain, M.D.NPI 1154344919
Title
Authorized Official
Phone
(510) 714-1879

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
Interventional Cardiology Physician 207RI0011X Primary

Addresses

Primary practice location

3077 Stevenson Blvd.
Fremont, CA 94538-2316

Mailing address

2333 Mowry Ave.
Suite 300
Fremont, CA 94538-1626
Phone (510) 796-0222

Other names 1

  • Advanced Interventional Surgical Center LLC Former legal business name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20181112000685 CA Part B Supplier - Clinic/Group Practice 1557615507 Receives reassigned benefits from 6 practitioners
Practice locations: Fremont, CA

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

National Provider Directory

National Provider Directory
Tax ID family
Advanced Interventional Surgical Center2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

Practitioners & affiliated clinicians

Practitioners 7

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": "1502323200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1542240000000",
    "number": "1215452297",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2333 MOWRY AVE.",
            "address_2": "SUITE 300",
            "city": "FREMONT",
            "state": "CA",
            "postal_code": "945381626",
            "telephone_number": "510-796-0222",
            "fax_number": "510-796-2215"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3077 STEVENSON BLVD.",
            "city": "FREMONT",
            "state": "CA",
            "postal_code": "945382316",
            "telephone_number": "510-714-1879",
            "fax_number": "510-796-2215"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ADVANCED INTERVENTIONAL SURGICAL CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-08-10",
        "last_updated": "2018-11-15",
        "status": "A",
        "authorized_official_last_name": "JAIN",
        "authorized_official_first_name": "ASHIT",
        "authorized_official_title_or_position": "AUTHORIZED OFFICIAL",
        "authorized_official_telephone_number": "510-714-1879",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207RI0011X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Interventional Cardiology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Advanced Interventional Surgical Center LLC",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in Fremont, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 15, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.