Nova Ambulatory Surgery Center LP

Primary specialty

Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X

Legal business name

NOVA AMBULATORY SURGERY CENTER LP

Practice address

4542 Las Posas Rd Ste C
Camarillo, CA 93010-2532

Phone

(805) 585-5004

Fax

(805) 484-3099

NPI assigned

Feb 11, 2020

Last updated

Apr 19, 2023By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Elida Pettyjohn

Title

Credentialing Acct Manager

Phone

(512) 454-5911

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1316579055. Details of each certification follow.

• CCN 55C0001112 Ambulatory surgical center · Active · Name & address match · Details

Ambulatory surgical center certification: CCN 55C0001112

Legal name

Nova Ambulatory Surgery Center LP

Certification status

Active

Provider type (POS)

Ambulatory surgical center

Participating since

Sep 16, 2021

Last certification

Aug 4, 2021

Ownership / control type

Proprietary

Facility address

4542 Las Posas Road, Suite C
Camarillo, CA 93010

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.

• Farid Kia, M.D

  • Pain Medicine (Physical Medicine & Rehabilitation) Physician
  • Camarillo, CA
  • NPI 1902053663
  NPD

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

{
    "created_epoch": "1581379200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1681862400000",
    "number": "1316579055",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3129",
            "city": "TORRANCE",
            "state": "CA",
            "postal_code": "905103129",
            "telephone_number": "310-792-3914",
            "fax_number": "855-898-4055"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4542 LAS POSAS RD STE C",
            "city": "CAMARILLO",
            "state": "CA",
            "postal_code": "930102532",
            "telephone_number": "805-585-5004",
            "fax_number": "805-484-3099"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NOVA AMBULATORY SURGERY CENTER LP",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-02-11",
        "last_updated": "2023-04-19",
        "certification_date": "2023-04-19",
        "status": "A",
        "authorized_official_last_name": "PETTYJOHN",
        "authorized_official_first_name": "ELIDA",
        "authorized_official_title_or_position": "CREDENTIALING ACCT MANAGER",
        "authorized_official_telephone_number": "512-454-5911"
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mireya Noris
• Terese C Norris, RN
• Cindy Norton
• Tiffany Janet Norton
• Nima Nourmand
• Naira Nova
• Melida Novoa, ACSW
• Nuclear Medicine Associates, Inc.
• Veronica J Nunes, CPT
• Irma Jiordana Nunez Ramos, BT

• Ambulatory Surgical Clinic/Center in Camarillo, CA
• Providers in Camarillo, 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 Apr 19, 2023; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.