Ocotillo Surgery Center LLC

Primary specialty

Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X

Legal business name

OCOTILLO SURGERY CENTER LLC

Practice address

3920 S Rome Street
Gilbert, AZ 85297

Phone

(480) 597-4778

NPI assigned

Nov 25, 2019

Organization subpart

No

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

Authorized official

Name

Dr. Matthew Moore, DONPI 1700076635

Title

Managing Member

Phone

(480) 597-4778

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in AZ

Enrollment records 1

Listed as

Ocotillo Surgery Center LLCCCN 03C0001412

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.

• Matthew David Moore, D.O.

  • Obstetrics & Gynecology Physician
  • Chandler, AZ
  • NPI 1700076635
  NPD Authorized official
• Albert Amini, M.D.

  • Surgery Physician
  • Chandler, AZ
  • NPI 1386890556
  NPD

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

{
    "created_epoch": "1574640000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1585094400000",
    "number": "1386280436",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1900 W FRYE RD STE 1",
            "city": "CHANDLER",
            "state": "AZ",
            "postal_code": "852246235"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3920 S ROME STREET",
            "city": "GILBERT",
            "state": "AZ",
            "postal_code": "85297",
            "telephone_number": "480-597-4778"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OCOTILLO SURGERY CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-11-25",
        "last_updated": "2020-03-25",
        "certification_date": "2020-03-25",
        "status": "A",
        "authorized_official_last_name": "MOORE",
        "authorized_official_first_name": "MATTHEW",
        "authorized_official_title_or_position": "MANAGING MEMBER",
        "authorized_official_telephone_number": "480-597-4778",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ana Obregon Duarte
• Sara Danielle Ocampo, SLT, SLPL
• Ocean Spine PLLC
• Latrice C Ochieng, MLE, CLT, HHP, BCHN
• Risa M Ochoa Jr.
• Ocotillo Treatment Center, LLC
• Jwan Odisho, AGACNP-BC
• Leo Odle, DO
• Marcia Odonnell
• Kristin N Oehler, APRN;FNP-C

• Ambulatory Surgical Clinic/Center in Gilbert, AZ
• Providers in Gilbert, AZ by specialty
• Ambulatory Surgical Clinic/Center in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 25, 2020; 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.