Organization Active NPI

Pacific Cardiovascular Surgeons a Medical Corporation

  • Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
  • Daly City, CA
National Provider Identifier
1295881860
Registry record updated Oct 21, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Thoracic Surgery (Cardiothoracic Vascular Surgery) PhysicianTaxonomy code 208G00000X
Legal business name
PACIFIC CARDIOVASCULAR SURGEONS A MEDICAL CORPORATION
Practice address
1800 Sullivan Ave
Suite 407
Daly City, CA 94015-2259
Phone
(650) 636-4462
Fax
(650) 636-4463
NPI assigned
Jan 26, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 21, 2024

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

Authorized official

Name
Mrs. Carmina Silve Paes
Title
Office Manager
Phone
(650) 991-2662

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Thoracic Surgery (Cardiothoracic Vascular Surgery) PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208G00000X Primary

Addresses

Primary practice location

1800 Sullivan Ave
Suite 407
Daly City, CA 94015-2259

Mailing address

1800 Sullivan Ave
Suite 407
Daly City, CA 94015-2259
Phone (650) 636-4462

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20090115000218 CA Part B Supplier - Clinic/Group Practice 0840353983 Receives reassigned benefits from 1 practitioner
Practice locations: Daly City, CA

National Provider Directory

National Provider Directory

Locations

1500 Southgate Ave
Ste 209
Daly City, CA 94015
Phone (650) 755-3000

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1169769600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1729468800000",
    "number": "1295881860",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1800 SULLIVAN AVE",
            "address_2": "SUITE 407",
            "city": "DALY CITY",
            "state": "CA",
            "postal_code": "940152259",
            "telephone_number": "650-636-4462",
            "fax_number": "650-636-4463"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1800 SULLIVAN AVE",
            "address_2": "SUITE 407",
            "city": "DALY CITY",
            "state": "CA",
            "postal_code": "940152259",
            "telephone_number": "650-636-4462",
            "fax_number": "650-636-4463"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PACIFIC CARDIOVASCULAR SURGEONS A MEDICAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-26",
        "last_updated": "2024-10-21",
        "certification_date": "2024-10-21",
        "status": "A",
        "authorized_official_last_name": "PAES",
        "authorized_official_first_name": "CARMINA",
        "authorized_official_middle_name": "SILVE",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "650-991-2662",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "208G00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Thoracic Surgery (Cardiothoracic Vascular Surgery)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Daly City, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 21, 2024; 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.