Spruce Surgery Center LLC

Primary specialty

Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X

Legal business name

SPRUCE SURGERY CENTER LLC

Practice address

10888 Foothill Blvd
Rancho Cucamonga, CA 91730-7651

Phone

(909) 463-0715

NPI assigned

Sep 16, 2022

Organization subpart

No

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

Authorized official

Name

Della Bennett, MDNPI 1649387952

Title

President

Phone

(909) 463-0715

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA2 enrollments

Enrollment records 2

Other NPIs on the same Medicare enrollment 2

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

• Arrowhead Eye Associates Inc

  • Ophthalmology Physician
  • Rancho Cucamonga, CA
  • NPI 1013466093

  O20161107000697

  Same enrollment
• Upland Outpatient Surgery Center LP

  • Ambulatory Surgical Clinic/Center
  • Ontario, CA
  • NPI 1710945787

  O20161107000697

  Same enrollment

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

CLIA laboratory certificates

Tax ID family

Arrowhead Eye Associates3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

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

• Arrowhead Eye Associates Inc

  • Ophthalmology Physician
  • Rancho Cucamonga, CA
  • NPI 1013466093
  NPD tax ID
• Arrowhead Eye Associates Inc

  • Ophthalmology Physician
  • Rancho Cucamonga, CA
  • NPI 1083075451
  NPD tax ID

Locations

Practitioners 6

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

• Della C Bennett, MD

  • Plastic and Reconstructive Surgery Physician
  • Rancho Cucamonga, CA
  • NPI 1649387952
  Medicare reassignment NPD Authorized official
• Cesar Emilio Aguiluz, D.O.

  • Plastic and Reconstructive Surgery Physician
  • Rancho Cucamonga, CA
  • NPI 1194004309
  Medicare reassignment NPD
• Jaskarn S Johl, DO

  • Ophthalmology Physician
  • Rancho Cucamonga, CA
  • NPI 1245492677
  NPD
• Jacob D Lopez, OD

  • Optometrist
  • Rancho Cucamonga, CA
  • NPI 1316783103
  NPD
• Apeksha Shah, MD

  • Ophthalmology Physician
  • Costa Mesa, CA
  • NPI 1053948125
  NPD
• Kris John Storkersen, MD

  • Ophthalmology Physician
  • Colton, CA
  • NPI 1154438935
  NPD

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

{
    "created_epoch": "1663286400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1727654400000",
    "number": "1457073322",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10888 FOOTHILL BLVD",
            "city": "RANCHO CUCAMONGA",
            "state": "CA",
            "postal_code": "917307651"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10888 FOOTHILL BLVD",
            "city": "RANCHO CUCAMONGA",
            "state": "CA",
            "postal_code": "917307651",
            "telephone_number": "909-463-0715"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SPRUCE SURGERY CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-09-16",
        "last_updated": "2024-09-30",
        "certification_date": "2024-09-30",
        "status": "A",
        "authorized_official_last_name": "BENNETT",
        "authorized_official_first_name": "DELLA",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "909-463-0715",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Spine Axis Medical, Inc.
• Spine Link Medical, Inc.
• Brian Spivack, M.D.
• Katelynn Spoerhase
• Alisha Springer
• Christopher Spurgeon, D.D.S.
• Warisara Srimuang
• SRK Clinic
• St. Augustine Hospice, Inc.
• St. Francis Home Health Agency, Inc.

• Ambulatory Surgical Clinic/Center in Rancho Cucamonga, CA
• Providers in Rancho Cucamonga, 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 Sep 30, 2024; 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.