Active NPI
Ventura Advanced Surgical Associates
- Specialist
- Ventura, CA
National Provider Identifier
1396862116
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Specialist
- Legal business name
- VENTURA ADVANCED SURGICAL ASSOCIATES
- Practice address
- 3200 Telegraph Rd
Ventura, CA 93003-3232 - Phone
- (916) 491-1717
- Fax
- (530) 432-4915
- NPI assigned
- Mar 25, 2007
- Last updated
- Jul 20, 2008
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Heather Jacobsen
- Title
- Insurance Coordinator
- Phone
- (916) 491-1717
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Specialist | 174400000X | NU | Primary |
Addresses
Primary practice location
3200 Telegraph Rd
Ventura, CA 93003-3232
Mailing address
3200 Telegraph Rd
Ventura, CA 93003-3232
Phone (916) 491-1717
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CA
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20040629001566 | CA | Part B Supplier - Clinic/Group Practice | 8527044486 |
Receives reassigned benefits from 2 practitioners 1 other NPI on this enrollment Practice locations: Santa Barbara, CA; Ventura, CA; Camarillo, CA |
Other NPIs on the same Medicare enrollment 1
NPIs listed together on one Medicare enrollment, typically parts of the same organization.
National Provider Directory
National Provider DirectoryLocations
3661 Las Posas Rd
Camarillo, CA 93010
Phone (805) 676-9100
124 N Brent St
Ventura, CA 93003
Phone (805) 641-9880
Interoperability endpoints
- https://api.platform.athenahealth.com/5067/brand/1/csg/1/fhir/r4
Practitioners & affiliated clinicians
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.
-
- Specialist
- Ventura, CA
- NPI 1447317664
-
- Internal Medicine Physician
- Ventura, CA
- NPI 1649367426
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1174780800000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1216512000000",
"number": "1396862116",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3200 TELEGRAPH RD",
"city": "VENTURA",
"state": "CA",
"postal_code": "930033232",
"telephone_number": "916-491-1717",
"fax_number": "530-432-4915"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3200 TELEGRAPH RD",
"city": "VENTURA",
"state": "CA",
"postal_code": "930033232",
"telephone_number": "916-491-1717",
"fax_number": "530-432-4915"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "VENTURA ADVANCED SURGICAL ASSOCIATES",
"organizational_subpart": "NO",
"enumeration_date": "2007-03-25",
"last_updated": "2008-07-20",
"status": "A",
"authorized_official_last_name": "JACOBSEN",
"authorized_official_first_name": "HEATHER",
"authorized_official_title_or_position": "INSURANCE COORDINATOR",
"authorized_official_telephone_number": "916-491-1717"
},
"taxonomies": [
{
"code": "174400000X",
"taxonomy_group": "",
"desc": "Specialist",
"state": "NU",
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Ventura, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 20, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.