NPIMap

Organization Active NPI

Trillium Med Spa Cosmetic Surgery and Laser Center

Doing business as Moorpark Women's Health & Spa

  • Obstetrics & Gynecology Physician
  • Moorpark, CA
National Provider Identifier
1467607127
Registry record updated Sep 19, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
Legal business name
TRILLIUM MED SPA COSMETIC SURGERY AND LASER CENTER
Doing business as
Moorpark Women's Health & Spa
Practice address
145 Park LN Ste 200
Moorpark, CA 93021-2117
Phone
(805) 531-9419
Fax
(805) 531-9494
NPI assigned
Nov 22, 2008
Last updated
Sep 19, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 19, 2023

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

Authorized official

Name
Troy Christopher WilliamsNPI 1093929630
Title
Owner
Phone
(818) 597-9300

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
Obstetrics & Gynecology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207V00000X Primary
Medical Specialty Clinic/Center 261QM2500X A103922 CA

Addresses

Primary practice location

145 Park LN Ste 200
Moorpark, CA 93021-2117

Mailing address

145 Park LN Ste 200
Moorpark, CA 93021-2117
Phone (805) 531-9419

Other names 1

  • Moorpark Women's Health & Spa Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20180817002050 CA Part B Supplier - Clinic/Group Practice 6103175500 Receives reassigned benefits from 5 practitioners
1 other NPI on this enrollment
Practice locations: Westlake Village, 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 Directory

Locations

32144 Agoura Rd
Ste 207
Westlake Vlg, CA 91361
Phone (805) 217-4055

Practitioners & affiliated clinicians

Practitioners 5

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": "1227312000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1695081600000",
    "number": "1467607127",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "145 PARK LN STE 200",
            "city": "MOORPARK",
            "state": "CA",
            "postal_code": "930212117",
            "telephone_number": "805-531-9419",
            "fax_number": "805-531-9494"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "145 PARK LN STE 200",
            "city": "MOORPARK",
            "state": "CA",
            "postal_code": "930212117",
            "telephone_number": "805-531-9419",
            "fax_number": "805-531-9494"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TRILLIUM MED SPA COSMETIC SURGERY AND LASER CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-11-22",
        "last_updated": "2023-09-19",
        "certification_date": "2023-09-19",
        "status": "A",
        "authorized_official_last_name": "WILLIAMS",
        "authorized_official_first_name": "TROY",
        "authorized_official_middle_name": "CHRISTOPHER",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "818-597-9300"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Obstetrics & Gynecology",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QM2500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Medical Specialty",
            "state": "CA",
            "license": "A103922",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Moorpark Women's Health & Spa",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Moorpark Women's Health & Spa",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Moorpark, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 19, 2023; 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.

Verify at the official NPI Registry.