El Dorado Surgery Center LLC

Primary specialty

Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X

Legal business name

EL DORADO SURGERY CENTER LLC

Practice address

4300 Golden Center Dr
Suite E
Placerville, CA 95667-6278

Phone

(530) 344-1687

Fax

(530) 344-1561

NPI assigned

Nov 25, 2008

Organization subpart

No

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

Authorized official

Name

Mrs. Tina M Heinrich, RN

Title

Facility Administrator

Phone

(530) 344-1687

Specialties & licenses 1

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Listed as

El Dorado Surgery Center LLCCCN 05C0001560

Medicare certification status

ActiveFrom the Provider of Services file

Member of 1

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

• Marshall Medical Center

  • Interventional Cardiology Physician
  • Placerville, CA
  • NPI 1215181664

  Member Of

  NPD member

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

{
    "created_epoch": "1227571200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1728950400000",
    "number": "1316192826",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4300 GOLDEN CENTER DR",
            "address_2": "SUITE E",
            "city": "PLACERVILLE",
            "state": "CA",
            "postal_code": "956676278",
            "telephone_number": "530-344-1687",
            "fax_number": "530-344-1561"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4300 GOLDEN CENTER DR",
            "address_2": "SUITE E",
            "city": "PLACERVILLE",
            "state": "CA",
            "postal_code": "956676278",
            "telephone_number": "530-344-1687",
            "fax_number": "530-344-1561"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EL DORADO SURGERY CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-11-25",
        "last_updated": "2024-10-15",
        "certification_date": "2024-10-15",
        "status": "A",
        "authorized_official_last_name": "HEINRICH",
        "authorized_official_first_name": "TINA",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "FACILITY ADMINISTRATOR",
        "authorized_official_telephone_number": "530-344-1687",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "RN"
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RAILROAD CARRIER",
            "identifier": "P00783630",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI NUMBER",
            "identifier": "1316192826",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "SUR01560F",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• El Dorado County, Department of Human Services
• El Dorado Hearing Center, Inc.
• El Dorado Mental Health
• El Dorado Pathology Medical Group, Inc
• El Dorado Recovery Center, LLC
• El Dorado Surgery Center, Inc.
• El Dorado Union School District
• Elder Options, Inc.
• Elder Options, Inc.
• Richard Emereonye, RN

• Ambulatory Surgical Clinic/Center in Placerville, CA
• Providers in Placerville, 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 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.