Pavilion Surgery Center LLC

Primary specialty

Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X

Legal business name

PAVILION SURGERY CENTER LLC

Practice address

1140 W la Veta Ave
Orange, CA 92868-4225

Phone

(714) 744-8711

NPI assigned

May 12, 2017

Organization subpart

No

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

Authorized official

Name

Brian Giessler

Title

Sr VP of ASC Ops & Business SVCS

Phone

(480) 207-3716

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Listed as

Pavilion Surgery CenterCCN 05C0002170

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

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

{
    "created_epoch": "1494547200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1522195200000",
    "number": "1356878052",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3033 N 44TH ST STE 200",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850187244"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1140 W LA VETA AVE",
            "city": "ORANGE",
            "state": "CA",
            "postal_code": "928684225",
            "telephone_number": "714-744-8711"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PAVILION SURGERY CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-05-12",
        "last_updated": "2018-03-28",
        "status": "A",
        "authorized_official_last_name": "GIESSLER",
        "authorized_official_first_name": "BRIAN",
        "authorized_official_title_or_position": "SR VP OF ASC OPS & BUSINESS SVCS",
        "authorized_official_telephone_number": "480-207-3716"
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Nancy Ostos Paulsen
• Karine Pauzuolis, RN, BSN, MSN, CRNA
• Mia Pavia
• Pavilion Family Physicians Medical Group Inc.
• Pavilion Neurology Medical Group Inc.
• Paving Forward Family Therapy Inc. (Paving Forward)
• Arthur Pavlovsky, MD
• No Name Given Pawan
• Ramandeep Kaur Pawar
• Marcella Payan

• 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 Mar 28, 2018; 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.