Santa Monica Advanced Surgical Institute LLC

Primary specialty

Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X

Legal business name

SANTA MONICA ADVANCED SURGICAL INSTITUTE LLC

Practice address

1908 Santa Monica Blvd Ste 5
Santa Monica, CA 90404-1927

Phone

(310) 829-5475

NPI assigned

Oct 7, 2019

Organization subpart

No

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

Authorized official

Name

Dr. Sadiqa Stelzner, MDNPI 1679596951

Title

Physician Owner

Phone

(310) 829-5475

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1255972642. Details of each certification follow.

• CCN 55C0001134 Ambulatory surgical center · Active · Name & address match · Details

Ambulatory surgical center certification: CCN 55C0001134

Legal name

Santa Monica Advanced Surgical Institute LLC

Certification status

Active

Provider type (POS)

Ambulatory surgical center

Participating since

Dec 3, 2022

Last certification

Dec 2, 2022

Ownership / control type

Proprietary

Facility address

1908 Santa Monica Blvd, Ste 5
Santa Monica, CA 90404

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

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.

• Sadiqa Stelzner, MD

  • Ophthalmology Physician
  • Santa Monica, CA
  • NPI 1679596951
  NPD Authorized official

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

{
    "created_epoch": "1570406400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1570406400000",
    "number": "1255972642",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1908 SANTA MONICA BLVD STE 5",
            "city": "SANTA MONICA",
            "state": "CA",
            "postal_code": "904041927",
            "telephone_number": "310-829-5475"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1908 SANTA MONICA BLVD STE 5",
            "city": "SANTA MONICA",
            "state": "CA",
            "postal_code": "904041927",
            "telephone_number": "310-829-5475"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SANTA MONICA ADVANCED SURGICAL INSTITUTE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-10-07",
        "last_updated": "2019-10-07",
        "status": "A",
        "authorized_official_last_name": "STELZNER",
        "authorized_official_first_name": "SADIQA",
        "authorized_official_title_or_position": "PHYSICIAN OWNER",
        "authorized_official_telephone_number": "310-829-5475",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Ambulatory Surgical Clinic/Center in Santa Monica, CA
• Providers in Santa Monica, 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, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
• 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.