Beverly Oaks Physicians Surgical Center, LLC

Primary specialty

Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X

Legal business name

BEVERLY OAKS PHYSICIANS SURGICAL CENTER, LLC

Practice address

4910 Van Nuys Blvd Ste 308
Sherman Oaks, CA 91403-1715

Phone

(818) 986-9099

NPI assigned

Oct 5, 2010

Last updated

Oct 21, 2014By 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

Mrs. Janetta Chernega

Title

Administrator

Phone

(818) 986-9099

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1396054599. Details of each certification follow.

• CCN 05C0001973 Ambulatory surgical center · Active · Name & address match · Details

Ambulatory surgical center certification: CCN 05C0001973

Legal name

BEVERLY OAKS PHYSICIAN SURGICAL CENTER, LLC

Certification status

Active

Provider type (POS)

Ambulatory surgical center

Participating since

Oct 30, 2011

Last certification

Feb 21, 2019

Ownership / control type

Proprietary

Facility address

4910 Van Nuys Boulevard, Suite 308
Sherman Oaks, CA 91403

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": "1286236800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1413849600000",
    "number": "1396054599",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3727 VENTURA CANYON AVE",
            "city": "SHERMAN OAKS",
            "state": "CA",
            "postal_code": "914234708",
            "telephone_number": "818-426-0886"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4910 VAN NUYS BLVD STE 308",
            "city": "SHERMAN OAKS",
            "state": "CA",
            "postal_code": "914031715",
            "telephone_number": "818-986-9099"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BEVERLY OAKS PHYSICIANS SURGICAL CENTER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-10-05",
        "last_updated": "2014-10-21",
        "status": "A",
        "authorized_official_last_name": "CHERNEGA",
        "authorized_official_first_name": "JANETTA",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "818-986-9099",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Ambulatory Surgical Clinic/Center in Sherman Oaks, CA
• Providers in Sherman Oaks, 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 Oct 21, 2014; 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.