NPIMap

Organization Active NPI

Physicians Surgery Services LLC

Doing business as Advanced Surgery Center

  • Ambulatory Surgical Clinic/Center
  • San Jose, CA
National Provider Identifier
1508942996
Registry record updated Mar 6, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X
License
550000041 Issued in CA
Legal business name
PHYSICIANS SURGERY SERVICES LLC
Doing business as
Advanced Surgery Center
Practice address
235 Oconnor Dr
San Jose, CA 95128-1624
Phone
(408) 279-0791
Fax
(408) 279-0797
NPI assigned
Oct 27, 2006
Last updated
Mar 6, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 6, 2025

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

Authorized official

Name
Jennifer Baldock
Title
Officer and Authorized Official
Phone
(615) 234-5954

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ambulatory Surgical Clinic/Center 261QA1903X 550000041 CA Primary

Addresses

Primary practice location

235 Oconnor Dr
San Jose, CA 95128-1624

Mailing address

235 Oconnor Dr
San Jose, CA 95128-1624
Phone (408) 279-0791

Other practice location 1

2039 Forest Ave Ste 101
San Jose, CA 95128-4815
Phone (408) 550-8650

Other names 1

  • Advanced Surgery Center Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20050819000433 CA Part B Supplier - Ambulatory Surgical Center 3971533811 Practice locations: San Jose, CA
O20190123002844 CA Part B Supplier - Ambulatory Surgical Center 3971533811 Practice locations: San Jose, CA

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1508942996. Details of each certification follow.

Ambulatory surgical center certification: CCN 05C0002222

Name & address match This certification has no NPI in the Medicare enrollment files. CMS publishes enrollment files for six facility types only, so it was connected to this NPI by matching the name and address CMS publishes for it.

Legal name
ADVANCED SURGERY CENTER
Certification status
Active
Provider type (POS)
Ambulatory surgical center
Participating since
Dec 6, 2019
Last certification
Dec 6, 2019
Ownership / control type
Proprietary
Facility address
2039 Forest Avenue, Suite 101
San Jose, CA 95128

Care Compare: Ambulatory surgical center

Medicare Care Compare
Listed as
Physicians Surgery Services LPCCN 05C0001723
Medicare certification status
ActiveFrom the Provider of Services file

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 16

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.

View all 16

NPI Registry JSON

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

{
    "created_epoch": "1161907200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1741219200000",
    "number": "1508942996",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "235 OCONNOR DR",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951281624",
            "telephone_number": "408-279-0791",
            "fax_number": "408-279-0797"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "235 OCONNOR DR",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951281624",
            "telephone_number": "408-279-0791",
            "fax_number": "408-279-0797"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2039 Forest Ave Ste 101",
            "address_purpose": "LOCATION",
            "city": "San Jose",
            "state": "CA",
            "postal_code": "951284815",
            "country_code": "US",
            "telephone_number": "408-550-8650",
            "fax_number": "408-550-8653",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "PHYSICIANS SURGERY SERVICES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-27",
        "last_updated": "2025-03-06",
        "certification_date": "2025-03-06",
        "status": "A",
        "authorized_official_last_name": "BALDOCK",
        "authorized_official_first_name": "JENNIFER",
        "authorized_official_title_or_position": "OFFICER AND AUTHORIZED OFFICIAL",
        "authorized_official_telephone_number": "615-234-5954"
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": "CA",
            "license": "550000041",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Advanced Surgery Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in San Jose, CA

Sources for this page

Verify at the official NPI Registry.