Orangewood Surgical Center LLC

Primary specialty

Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X

Legal business name

ORANGEWOOD SURGICAL CENTER LLC

Practice address

2143 W Orangewood Ave
Orange, CA 92868-1941

Phone

(714) 221-4236

NPI assigned

Jan 9, 2008

Last updated

Jan 28, 2009By 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

Dr. Alvaro Liceaga, MD

Title

Medical Director

Phone

(714) 221-4236

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 1326223298. Details of each certification follow.

• CCN 05C0001883 Ambulatory surgical center · Active · Name & address match · Details

Ambulatory surgical center certification: CCN 05C0001883

Legal name

Orangewood Surgical Center LLC

Certification status

Active

Provider type (POS)

Ambulatory surgical center

Participating since

Jan 29, 2009

Last certification

Aug 23, 2019

Ownership / control type

Proprietary

Facility address

2143 Orangewood Avenue
Orange, CA 92868

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

CLIA laboratory certificates

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.

• John Francis Petraglia, M.D.

  • Interventional Pain Medicine Physician
  • Newport Beach, CA
  • NPI 1417933938
  NPD (past)

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

{
    "created_epoch": "1199836800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1233100800000",
    "number": "1326223298",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2143 ORANGEWOOD AVE",
            "city": "ORANGE",
            "state": "CA",
            "postal_code": "90051",
            "telephone_number": "714-221-4236"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2143 W ORANGEWOOD AVE",
            "city": "ORANGE",
            "state": "CA",
            "postal_code": "928681941",
            "telephone_number": "714-221-4236"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ORANGEWOOD SURGICAL CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-01-09",
        "last_updated": "2009-01-28",
        "status": "A",
        "authorized_official_last_name": "LICEAGA",
        "authorized_official_first_name": "ALVARO",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "714-221-4236",
        "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": []
}

• Orange Unified School District
• Orange Village Optometry
• Aries Renette Orange
• Orangewood Children and Family Center - Cast
• Orangewood Medical Clinic Inc
• Brenda Ordaz
• Siboney Ordaz, MSW
• Maria Jose Ordenana, RN FNP
• Michael Ordon, M.D.
• Narin Ordoubadi

• Ambulatory Surgical Clinic/Center in Orange, CA
• Providers in Orange, 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 Jan 28, 2009; 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.