NPIMap

Organization Active NPI

Plasticare Surgery Center LLC

  • Ambulatory Surgical Clinic/Center
  • Long Beach, CA
National Provider Identifier
1437402054
Registry record updated Oct 19, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X
License
1386(AAAASF) Issued in IL
Legal business name
PLASTICARE SURGERY CENTER LLC
Practice address
920 East Wardlow Road
Long Beach, CA 90807-4630
Phone
(562) 427-8944
Fax
(562) 427-4086
NPI assigned
Oct 19, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 19, 2012

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

Authorized official

Name
Ikonija Sekulovich Joy, MDNPI 1528164126
Title
Director Plasticare Surgery Center
Phone
(562) 427-8944

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Plastic Surgery PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208200000X G25370 CA
Ambulatory Surgical Clinic/Center 261QA1903X 1386(AAAASF) IL Primary

Addresses

Primary practice location

920 East Wardlow Road
Long Beach, CA 90807-4630

Mailing address

920 East Wardlow Road
Long Beach, CA 90807-4630
Phone (562) 427-8944

Other names 1

  • Plasticare Surgery Center Former legal business name

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 3

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

NPI Registry JSON

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

{
    "created_epoch": "1350604800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1350604800000",
    "number": "1437402054",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "920 EAST WARDLOW ROAD",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "908074630",
            "telephone_number": "562-427-8944",
            "fax_number": "562-427-4086"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "920 EAST WARDLOW ROAD",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "908074630",
            "telephone_number": "562-427-8944",
            "fax_number": "562-427-4086"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PLASTICARE SURGERY CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-10-19",
        "last_updated": "2012-10-19",
        "status": "A",
        "authorized_official_last_name": "JOY",
        "authorized_official_first_name": "IKONIJA",
        "authorized_official_middle_name": "SEKULOVICH",
        "authorized_official_title_or_position": "DIRECTOR PLASTICARE SURGERY CENTER",
        "authorized_official_telephone_number": "562-427-8944",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208200000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Plastic Surgery",
            "state": "CA",
            "license": "G25370",
            "primary": false
        },
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": "IL",
            "license": "1386(AAAASF)",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Plasticare Surgery Center",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in Long Beach, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 19, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.