Newport Beach Surgery Center, LLC

Primary specialty

Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X

License

060000339 Issued in CA

Legal business name

NEWPORT BEACH SURGERY CENTER, LLC

Doing business as

Newport Beach Surgery Center

Practice address

361 Hospital Road
Suite 124
Newport Beach, CA 92663

Phone

(949) 631-0988

Fax

(949) 631-2504

NPI assigned

Jun 2, 2005

Last updated

May 5, 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

Leroy Trey Sampson III

Title

Administrator

Phone

(949) 631-0988

Specialties & licenses 1

Addresses

Other names 1

• Newport Beach Surgery Center Doing business as

Medicare fee-for-service enrollment

Enrolled in CA2 enrollments

Enrollment records 2

Other NPIs on the same Medicare enrollment 2

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

• Hoag Memorial Hospital Presbyterian

  • General Acute Care Hospital
  • Newport Beach, CA
  • NPI 1518951300

  O20070518000178

  Same enrollment
• Michael a Bain MD Inc

  • Plastic Surgery Physician
  • Newport Beach, CA
  • NPI 1841341377

  O20070518000178

  Same enrollment

Listed as

Newport Beach Surgery Center L PCCN 05C0001243

Medicare certification status

ActiveFrom the Provider of Services file

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 2

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.

• Michael A Bain, MD

  • Plastic Surgery Physician
  • Newport Beach, CA
  • NPI 1316029341
  NPD
• Jennifer Bianca Vincent, PA-C

  • Physician Assistant
  • San Juan Capistrano, CA
  • NPI 1164986105
  NPD

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

{
    "created_epoch": "1117670400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1683244800000",
    "number": "1316949415",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "361 HOSPITAL ROAD",
            "address_2": "SUITE 124",
            "city": "NEWPORT BEACH",
            "state": "CA",
            "postal_code": "92663",
            "telephone_number": "949-631-0988",
            "fax_number": "949-631-2504"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "361 HOSPITAL ROAD",
            "address_2": "SUITE 124",
            "city": "NEWPORT BEACH",
            "state": "CA",
            "postal_code": "92663",
            "telephone_number": "949-631-0988",
            "fax_number": "949-631-2504"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NEWPORT BEACH SURGERY CENTER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-06-02",
        "last_updated": "2023-05-05",
        "certification_date": "2023-05-05",
        "status": "A",
        "authorized_official_last_name": "SAMPSON",
        "authorized_official_first_name": "LEROY",
        "authorized_official_middle_name": "TREY",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "949-631-0988",
        "authorized_official_name_suffix": "III"
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": "CA",
            "license": "060000339",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Newport Beach Surgery Center",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Newport Beach Surgery Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Newport Beach Neurosurgical Institute
• Newport Beach OB/GYN Medical Group Inc
• Newport Beach Pediatric Pulmonology, Inc.
• Newport Beach Radiosurgery Center, LLC
• Newport Beach Recovery Center
• Newport Beach Surgical and Medical Group Inc
• Newport Beach Trauma Therapy, Inc
• Newport Beach Womens Wellness Center
• Newport Brachytherapy Institute, Inc.
• Newport Cardiac & Thoracic Surgery, Inc.

• Ambulatory Surgical Clinic/Center in Newport Beach, CA
• Providers in Newport Beach, 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 May 5, 2023; 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.