Inland Ear Nose and Throat a Medical Group Inc

Primary specialty

Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X

Legal business name

INLAND EAR NOSE AND THROAT A MEDICAL GROUP INC

Doing business as

Foothill Ambulatory Surgery Center

Practice address

1030 E Foothill Blvd
Suite 101B
Upland, CA 91786

Phone

(909) 981-5859

Fax

(909) 981-8293

NPI assigned

May 10, 2006

Last updated

Jun 24, 2016By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Natee Poopat, MDNPI 1760492821

Title

President

Phone

(909) 981-5859

Specialties & licenses 1

Addresses

Other names 1

• FOOTHILL AMBULATORY SURGERY CENTER Doing business as

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1477502979. Details of each certification follow.

• CCN 05C0001253 Ambulatory surgical center · Active · Name & address match · Details

Ambulatory surgical center certification: CCN 05C0001253

Legal name

FOOTHILL AMBULATORY SURGERY CENTER

Certification status

Active

Provider type (POS)

Ambulatory surgical center

Participating since

Jan 20, 1993

Last certification

Apr 30, 2019

Ownership / control type

Proprietary

Facility address

1030 East Foothill Blvd #101B
Upland, CA 91786

Other NPIs with the same Medicare PAC ID 1

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

• Inland Ear Nose and Throat a Medical Group Inc

  • Otolaryngology Physician
  • Upland, CA
  • NPI 1073612784

  7911987979

  Same PAC ID

Tax ID family

Foothill Ambulatory Surg Ctr2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

• Inland Ear Nose and Throat a Medical Group Inc

  • Otolaryngology Physician
  • Upland, CA
  • NPI 1073612784
  NPD tax ID

Locations

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.

• Natee Poopat, MD

  • Otolaryngology/Facial Plastic Surgery Physician
  • Upland, CA
  • NPI 1760492821
  Medicare reassignment Authorized official
• Clara Man-Ching Olcott, M.D.

  • Otolaryngology Physician
  • Upland, CA
  • NPI 1215291612
  Medicare reassignment NPD

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

{
    "created_epoch": "1147219200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1466726400000",
    "number": "1477502979",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1030 E FOOTHILL BLVD",
            "address_2": "SUITE 101B",
            "city": "UPLAND",
            "state": "CA",
            "postal_code": "91786",
            "telephone_number": "909-981-5859",
            "fax_number": "909-981-8293"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1030 E FOOTHILL BLVD",
            "address_2": "SUITE 101B",
            "city": "UPLAND",
            "state": "CA",
            "postal_code": "91786",
            "telephone_number": "909-981-5859",
            "fax_number": "909-981-8293"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INLAND EAR NOSE AND THROAT A MEDICAL GROUP INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-10",
        "last_updated": "2016-06-24",
        "status": "A",
        "authorized_official_last_name": "POOPAT",
        "authorized_official_first_name": "NATEE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "909-981-5859",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "FOOTHILL AMBULATORY SURGERY CENTER",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Amanda Ingalls, PA-C
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• Inland Cardiology Heart Failure Clinic
• Inland Ear Nose and Throat a Medical Group Inc
• Inland Empire Dental Group
• Inland Empire Medical Network,Inc.
• Inland Empire OBGYN Registry Inc
• Inland Empire Surgery Center, Inc.
• Inland Family Healthcare Centers, Inc.

• Ambulatory Surgical Clinic/Center in Upland, CA
• Providers in Upland, 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 Jun 24, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.