Organization Active NPI

Samaritan Plastic Surgery Center, Inc

  • Ambulatory Surgical Clinic/Center
  • San Jose, CA
National Provider Identifier
1487850350
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X
Legal business name
SAMARITAN PLASTIC SURGERY CENTER, INC
Practice address
2550 Samaritan Dr
San Jose, CA 95124-4104
Phone
(408) 358-3164
Fax
(408) 358-1088
NPI assigned
Jun 26, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dr. Gaeton Nola, MD
Title
President
Phone
(408) 358-3164

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ambulatory Surgical Clinic/Center 261QA1903X Primary

Addresses

Primary practice location

2550 Samaritan Dr
San Jose, CA 95124-4104

Mailing address

2550 Samaritan Dr
San Jose, CA 95124-4104
Phone (408) 358-3164

Other identifiers 1

IdentifierTypeStateIssuer
CERTIFICATION # 1602OtherAAAASF

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1182816000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1487850350",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2550 SAMARITAN DR",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951244104",
            "telephone_number": "408-358-3164",
            "fax_number": "408-358-1088"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2550 SAMARITAN DR",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951244104",
            "telephone_number": "408-358-3164",
            "fax_number": "408-358-1088"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SAMARITAN PLASTIC SURGERY CENTER, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-06-26",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "NOLA",
        "authorized_official_first_name": "GAETON",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "408-358-3164",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AAAASF",
            "identifier": "CERTIFICATION # 1602",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in San Jose, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.