Lompoc Surgery Center LLC

Primary specialty

Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X

Legal business name

LOMPOC SURGERY CENTER LLC

Practice address

215 N H St
Lompoc, CA 93436-6021

Phone

(805) 406-3627

NPI assigned

Mar 25, 2024

Last updated

Aug 18, 2025By 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

Polly J Baldwin

Title

Administrator

Phone

(805) 588-7984

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 1396595245. Details of each certification follow.

• CCN 55C0001189 Ambulatory surgical center · Active · Name & address match · Details

Ambulatory surgical center certification: CCN 55C0001189

Legal name

Lompoc Surgery Center, LLC

Certification status

Active

Provider type (POS)

Ambulatory surgical center

Participating since

Jun 18, 2025

Last certification

May 27, 2025

Facility address

215 North H Street, Suite B
Lompoc, CA 93436

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, and the practitioner matching its NPPES authorized official.

• Randall Goodman, MD

  • Ophthalmology Physician
  • Santa Maria, CA
  • NPI 1891788436
  NPD
• Rahim A Raoufi, MD

  • Gastroenterology Physician
  • Lompoc, CA
  • NPI 1356327597
  NPD

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

{
    "created_epoch": "1711324800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1755475200000",
    "number": "1396595245",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "215 N H ST STE B",
            "city": "LOMPOC",
            "state": "CA",
            "postal_code": "934366037",
            "telephone_number": "805-888-4511",
            "fax_number": "805-888-4513"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "215 N H ST",
            "city": "LOMPOC",
            "state": "CA",
            "postal_code": "934366021",
            "telephone_number": "805-406-3627"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LOMPOC SURGERY CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-03-25",
        "last_updated": "2025-08-18",
        "certification_date": "2025-08-18",
        "status": "A",
        "authorized_official_last_name": "BALDWIN",
        "authorized_official_first_name": "POLLY",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "805-588-7984"
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lompoc Anesthesia Services, PC
• Lompoc Artificial Kidney Center, LLC
• Lompoc Hospitalist Group PC
• Lompoc Misc
• Lompoc Orthopedic Medical Clinic
• Lompoc Unified School District
• Lompoc Valley Anesthesia Associates
• Lompoc Valley Medical Center
• Lompoc Valley Medical Center
• Lompoc Valley Medical Center

• Ambulatory Surgical Clinic/Center in Lompoc, CA
• Providers in Lompoc, 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 Aug 18, 2025; 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.