Irvine Surgical Medical Group Corp

Primary specialty

Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X

License

550000008 Issued in CA

Legal business name

IRVINE SURGICAL MEDICAL GROUP CORP

Practice address

15825 Laguna Canyon Rd
Suite 100
Irvine, CA 92618-2125

Phone

(949) 679-6700

Fax

(949) 387-9530

NPI assigned

Oct 12, 2006

Organization subpart

No

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

Authorized official

Name

Ardalan Babaknia, PHD,M.D.NPI 1366527491

Title

Chief Medical Director and Financia

Phone

(949) 753-8844

Specialties & licenses 1

Addresses

Other identifiers 3

Other names 1

• IRVINE ENDOSCOPY AND SURGICAL INSTITUTE Other name

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Listed as

Irvine Endoscopy and Surgical Institute Dba United Surgery Center IrvineCCN 05C0001683

Medicare certification status

ActiveFrom the Provider of Services file

Practitioners 1

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

• Ardalan Babaknia, MD

  • Gastroenterology Physician
  • Irvine, CA
  • NPI 1366527491
  NPD Authorized official

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

{
    "created_epoch": "1160611200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1210809600000",
    "number": "1578652152",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15825 LAGUNA CANYON RD",
            "address_2": "SUITE 100",
            "city": "IRVINE",
            "state": "CA",
            "postal_code": "926182125",
            "telephone_number": "949-679-6700",
            "fax_number": "949-387-9530"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15825 LAGUNA CANYON RD",
            "address_2": "SUITE 100",
            "city": "IRVINE",
            "state": "CA",
            "postal_code": "926182125",
            "telephone_number": "949-679-6700",
            "fax_number": "949-387-9530"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "IRVINE SURGICAL MEDICAL GROUP CORP",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-12",
        "last_updated": "2008-05-15",
        "status": "A",
        "authorized_official_last_name": "BABAKNIA",
        "authorized_official_first_name": "ARDALAN",
        "authorized_official_title_or_position": "CHIEF MEDICAL DIRECTOR AND FINANCIA",
        "authorized_official_telephone_number": "949-753-8844",
        "authorized_official_credential": "PHD,M.D."
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": "CA",
            "license": "550000008",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "SUR01683F",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DHS STATE LICENSE",
            "identifier": "550000008",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CLIA",
            "identifier": "05D1025785",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "IRVINE ENDOSCOPY AND SURGICAL INSTITUTE",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Irvine Rehabilitation Hospital LLC
• Irvine Specialty Care Surgery Center
• Irvine Spectrum Dental
• Irvine Surgical Center II LLC
• Irvine Surgical Center LLC
• Irvine Surgical Partners LLC
• Irvine Therapy Services, Inc.
• Irvine Unified School District
• Irvine Unified School District
• Irvine Unified School District

• Ambulatory Surgical Clinic/Center in Irvine, CA
• Providers in Irvine, 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 15, 2008; 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.