Foothill Gateway Surgery Center LLC

Primary specialty

Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X

Legal business name

FOOTHILL GATEWAY SURGERY CENTER LLC

Practice address

29300 Portola Pkwy Ste a
Lake Forest, CA 92630-8718

Phone

(949) 305-6336

Fax

(949) 767-5764

NPI assigned

Feb 20, 2007

Last updated

Oct 22, 2010By 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

Patti Thompson

Title

Billing Manager

Phone

(949) 305-6336

Specialties & licenses 1

Addresses

Listed as

Foothill Gateway Surgery CenterCCN 05C0001686

Medicare certification status

Terminated Voluntary: merger or closure, Jan 1, 2025From the Provider of Services file

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Practitioners 1

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.

• Richard R Moy, DPM

  • Foot & Ankle Surgery Podiatrist
  • Lake Forest, CA
  • NPI 1700831971
  NPD

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

{
    "created_epoch": "1171929600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1287705600000",
    "number": "1588709489",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "29300 PORTOLA PKWY STE A",
            "city": "LAKE FOREST",
            "state": "CA",
            "postal_code": "926308718",
            "telephone_number": "949-305-6336",
            "fax_number": "949-767-5764"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "29300 PORTOLA PKWY STE A",
            "city": "LAKE FOREST",
            "state": "CA",
            "postal_code": "926308718",
            "telephone_number": "949-305-6336",
            "fax_number": "949-767-5764"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FOOTHILL GATEWAY SURGERY CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-20",
        "last_updated": "2010-10-22",
        "status": "A",
        "authorized_official_last_name": "THOMPSON",
        "authorized_official_first_name": "PATTI",
        "authorized_official_title_or_position": "BILLING MANAGER",
        "authorized_official_telephone_number": "949-305-6336"
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Paula Flores
• Flourish Speech Therapy Inc.
• Anthony Ernest Follico, DDS
• Jasmine Fonseca Ruiz
• Jessica A Fonseca
• Foothill Surgical Institute, LLC
• Carol Ann Ford Shintani, R.N.
• Forest Massage
• Rosalie Aguilar Forestier
• Lauren Forrest

• Ambulatory Surgical Clinic/Center in Lake Forest, CA
• Providers in Lake Forest, 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 Oct 22, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• 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.