South Placer Surgery Center L P

Primary specialty

Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X

License

03000772 Issued in CA

Legal business name

SOUTH PLACER SURGERY CENTER L P

Doing business as

Sutter Sierra Surgery Center

Practice address

8 Medical Plaza Drive
Suite 100
Roseville, CA 95661-2185

Phone

(916) 677-5070

Fax

(916) 677-5071

NPI assigned

Jul 15, 2005

Organization subpart

No

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

Authorized official

Name

Bradley Heaton

Title

Ceo

Phone

(916) 566-4907

Specialties & licenses 1

Addresses

Other identifiers 4

Other names 1

• Sutter Sierra Surgery Center Doing business as

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Listed as

South Placer Surgery Center LPCCN 05C0001608

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 1

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

• Sutter Valley Medical Foundation

  dba Stockton Surgery Center

  • Ambulatory Surgical Clinic/Center
  • Stockton, CA
  • NPI 1467825844

  Member Of

  NPD member

Locations

Practitioners 1

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

• Robert D. Jamieson, D.O.

  • Orthopaedic Surgery Physician
  • St George, UT
  • NPI 1528220522
  NPD (past)

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

{
    "created_epoch": "1121385600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1715040000000",
    "number": "1467451096",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8 MEDICAL PLAZA DRIVE",
            "address_2": "SUITE 100",
            "city": "ROSEVILLE",
            "state": "CA",
            "postal_code": "956612185",
            "telephone_number": "916-577-5070",
            "fax_number": "916-577-5071"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8 MEDICAL PLAZA DRIVE",
            "address_2": "SUITE 100",
            "city": "ROSEVILLE",
            "state": "CA",
            "postal_code": "956612185",
            "telephone_number": "916-677-5070",
            "fax_number": "916-677-5071"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTH PLACER SURGERY CENTER L P",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-07-15",
        "last_updated": "2024-05-07",
        "certification_date": "2024-05-07",
        "status": "A",
        "authorized_official_last_name": "HEATON",
        "authorized_official_first_name": "BRADLEY",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "916-566-4907"
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": "CA",
            "license": "03000772",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "US DEPT OF LABOR",
            "identifier": "220182400",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "SUR01608F",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD",
            "identifier": "ZZZH3100Z",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "AS1608",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Sutter Sierra Surgery Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Isabella Soto
• Julia Anna Soto, MSW, LCSW
• Aryan Sotoodeh, DO
• Panumas Soukaroon, OTR/L
• Alexander Visal Sour
• Anita Mieko Southard
• Alyssa Southwick, SLPA
• Anthony Souza
• Brandi Souza
• Janelle Helen Souza

• Ambulatory Surgical Clinic/Center in Roseville, CA
• Providers in Roseville, 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 May 7, 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.