Northern California Surgical Associates, Inc.

Primary specialty

Surgery PhysicianTaxonomy code 208600000X

License

A99595 Issued in CA

Legal business name

NORTHERN CALIFORNIA SURGICAL ASSOCIATES, INC.

Practice address

8120 Timberlake Way
Suite 109
Sacramento, CA 95823-5412

Phone

(916) 688-7000

Fax

(916) 688-7005

NPI assigned

Jul 18, 2011

Organization subpart

No

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

Authorized official

Name

Benjamin Dean Shadle, MD

Title

President

Phone

(916) 688-7000

Specialties & licenses 1

Addresses

Other names 1

• Benjamin D. Shadle, MD, Inc. Former legal business name

Locations

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

{
    "created_epoch": "1310947200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1336435200000",
    "number": "1396033882",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8120 TIMBERLAKE WAY",
            "address_2": "SUITE 109",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958235412",
            "telephone_number": "916-688-7000",
            "fax_number": "916-688-7005"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8120 TIMBERLAKE WAY",
            "address_2": "SUITE 109",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958235412",
            "telephone_number": "916-688-7000",
            "fax_number": "916-688-7005"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTHERN CALIFORNIA SURGICAL ASSOCIATES, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-07-18",
        "last_updated": "2012-05-08",
        "status": "A",
        "authorized_official_last_name": "SHADLE",
        "authorized_official_first_name": "BENJAMIN",
        "authorized_official_middle_name": "DEAN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "916-688-7000",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Surgery",
            "state": "CA",
            "license": "A99595",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Benjamin D. Shadle, MD, Inc.",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

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• Northern California P.E.T. Imaging Center
• Northern California Specialty Surgical Center
• Ashli Northern
• Northgate Dentists
• Northlight Wellness, a Professional Nursing Corporation
• Northstar Home Care LLC
• Northstar Psychology Group, Inc.

• Surgery Physician in Sacramento, CA
• Providers in Sacramento, CA by specialty
• Surgery Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 8, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.