NPIMap

Organization Active NPI

Monterey Peninsula Surgery Center LLC

Doing business as Capitola Surgery Center

  • Ambulatory Surgical Clinic/Center
  • Capitola, CA
National Provider Identifier
1407116361
Registry record updated Dec 31, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X
Legal business name
MONTEREY PENINSULA SURGERY CENTER LLC
Doing business as
Capitola Surgery Center
Practice address
2265 41St Avenue
Capitola, CA 95010
Phone
(831) 372-2169
Fax
(831) 372-6323
NPI assigned
May 24, 2012
Last updated
Dec 31, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 31, 2025

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

Authorized official

Name
Ms. Carrie Millsap, BSN
Title
Ceo
Phone
(831) 372-2169

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ambulatory Surgical Clinic/Center 261QA1903X NU Primary

Addresses

Primary practice location

2265 41St Avenue
Capitola, CA 95010

Mailing address

9699 Blue Larkspur LN Ste 202
Monterey, CA 93940-6552
Phone (831) 372-2169

Other names 1

  • Capitola Surgery Center Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20251031003754 CA Part B Supplier - Ambulatory Surgical Center 4587744974 Practice locations: Capitola, CA

Other NPIs with the same Medicare PAC ID 4

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Care Compare: Ambulatory surgical center

Medicare Care Compare
Listed as
Capitola Surgery CenterCCN 05C0002005
Medicare certification status
ActiveFrom the Provider of Services file

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
05D2051707Capitola Surgery Center2265 41St Ave, Capitola, CA 95010Certificate of waiverDec 25, 2026

National Provider Directory

National Provider Directory
Tax ID family
Montery Penn Surg Ctr LLC4 organizations share this tax ID, including this one
Part of
Montery Penn Surg Ctr LLC

Other organizations with this tax ID 3

Organizations that report the same tax identification number in the National Provider Directory.

Member of 3

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

Locations

9699 Blue Larkspur Ln
Monterey, CA 93940

9699 Blue Larkspur Ln
Ste 202
Monterey, CA 93940

9699 Blue Larkspur Ln
Ste 220
Monterey, CA 93940

955 Blanco Cir
Ste A
Salinas, CA 93901
Phone (831) 753-5800

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.

NPI Registry JSON

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

{
    "created_epoch": "1337817600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1767139200000",
    "number": "1407116361",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9699 BLUE LARKSPUR LN STE 202",
            "city": "MONTEREY",
            "state": "CA",
            "postal_code": "939406552",
            "telephone_number": "831-372-2169",
            "fax_number": "831-372-6323"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2265 41ST AVENUE",
            "city": "CAPITOLA",
            "state": "CA",
            "postal_code": "95010",
            "telephone_number": "831-372-2169",
            "fax_number": "831-372-6323"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MONTEREY PENINSULA SURGERY CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-05-24",
        "last_updated": "2025-12-31",
        "certification_date": "2025-12-31",
        "status": "A",
        "authorized_official_last_name": "MILLSAP",
        "authorized_official_first_name": "CARRIE",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "831-372-2169",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "BSN"
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Capitola Surgery Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Capitola, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 31, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.