Galileo Surgery Center, LP

Primary specialty

Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X

Legal business name

GALILEO SURGERY CENTER, LP

Practice address

1001 E Foothill Blvd
San Luis Obispo, CA 93405-1815

Phone

(805) 782-8222

Fax

(805) 782-8220

NPI assigned

May 23, 2005

Organization subpart

No

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

Authorized official

Name

Mr. Boris I Pilch, MD

Title

Managing Partner

Phone

(805) 597-8370

Specialties & licenses 1

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Enrolled in CA2 enrollments

Enrollment records 2

Ambulatory surgical center certification: CCN 05C0002092

Legal name

GALILEO SURGERY CENTER, LP

Certification status

Active

Provider type (POS)

Ambulatory surgical center

Participating since

Nov 9, 2015

Last certification

Aug 11, 2021

Ownership / control type

Proprietary

Facility address

5000 San Palo Road Suite #100
Atascadero, CA 93422

Listed as

Galileo Surgery Center LPCCN 05C0001448

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

Member of 2

Organizations this organization is a member of, according to the National Provider Directory.

• Russ L Levitan MD Inc

  • Pain Medicine (Anesthesiology) Physician
  • San Luis Obispo, CA
  • NPI 1689470122

  Member Of

  NPD member
• SP Medical Consultants, Inc.

  • Interventional Pain Medicine Physician
  • Santa Maria, CA
  • NPI 1982451514

  Member Of

  NPD member

Locations

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Philip J Citek, MD

  • Pain Medicine (Physical Medicine & Rehabilitation) Physician
  • Atascadero, CA
  • NPI 1275633232
  NPD (past)
• Alexander A Krakovsky, M.D.

  • Specialist
  • La Jolla, CA
  • NPI 1023096443
  NPD (past)
• Timothy Kuang, M.D.

  • Pain Medicine (Physical Medicine & Rehabilitation) Physician
  • San Luis Obispo, CA
  • NPI 1134107550
  NPD (past)
• Victoria Ann Mahony, CRNA

  • Certified Registered Nurse Anesthetist
  • Los Angeles, CA
  • NPI 1649259359
  NPD (past)

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

{
    "created_epoch": "1116806400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1657065600000",
    "number": "1396748547",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 5458",
            "city": "SAN LUIS OBISPO",
            "state": "CA",
            "postal_code": "934035458",
            "telephone_number": "805-786-4878",
            "fax_number": "805-597-8350"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1001 E FOOTHILL BLVD",
            "city": "SAN LUIS OBISPO",
            "state": "CA",
            "postal_code": "934051815",
            "telephone_number": "805-782-8222",
            "fax_number": "805-782-8220"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5000 San Palo Rd",
            "address_purpose": "LOCATION",
            "city": "Atascadero",
            "state": "CA",
            "postal_code": "934222481",
            "country_code": "US",
            "telephone_number": "805-703-2030",
            "fax_number": "805-703-2034",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1300 E Cypress St Ste E1",
            "address_purpose": "LOCATION",
            "city": "Santa Maria",
            "state": "CA",
            "postal_code": "934544736",
            "country_code": "US",
            "telephone_number": "805-361-5088",
            "fax_number": "805-361-5085",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "GALILEO SURGERY CENTER, LP",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-05-23",
        "last_updated": "2022-07-06",
        "certification_date": "2022-07-06",
        "status": "A",
        "authorized_official_last_name": "PILCH",
        "authorized_official_first_name": "BORIS",
        "authorized_official_middle_name": "I",
        "authorized_official_title_or_position": "MANAGING PARTNER",
        "authorized_official_telephone_number": "805-597-8370",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "05C0001448",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "CB235712",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "S051448",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Elisabeth Gaertner
• Mandy R.C. Gailey, RD
• Linda Ann Galanos, RN, NP
• Cathy Jane Galavotti, PSY.D.
• Galen Inpatient Physicians PC
• Rachel Galinato
• Fatima Galindo
• Jordan Gallagher, AMFT
• Mary Gallagher, P.T.
• Paul Arthur Gallagher, M.D.

• Ambulatory Surgical Clinic/Center in San Luis Obispo, CA
• Providers in San Luis Obispo, 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 Jul 6, 2022; 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.