Poway Ca Multi Specialty ASC LLC

Primary specialty

Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X

Legal business name

POWAY CA MULTI SPECIALTY ASC LLC

Doing business as

Poway Surgery Center

Practice address

15611 Pomerado Rd Ste 220
Poway, CA 92064-2437

Phone

(858) 521-0031

Fax

(858) 521-0921

NPI assigned

Dec 18, 2007

Last updated

Jan 20, 2023By 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

Mr. Jeffrey Snodgrass

Title

President

Phone

(615) 665-1283

Specialties & licenses 1

Addresses

Other names 1

• Poway Surgery Center Doing business as

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Listed as

Poway Surgery CenterCCN 05C0001583

Medicare certification status

ActiveFrom 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

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

• Palomar Health

  dba The Villas at Poway

  • Skilled Nursing Facility
  • Poway, CA
  • NPI 1619947090

  Member Of

  NPD member

Locations

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

{
    "created_epoch": "1197936000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1674172800000",
    "number": "1598949281",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1A BURTON HILLS BLVD.",
            "address_2": "LICENSURE AND CERT DEPT",
            "city": "NASHVILLE",
            "state": "TN",
            "postal_code": "372156187",
            "telephone_number": "615-263-4011"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15611 POMERADO RD STE 220",
            "city": "POWAY",
            "state": "CA",
            "postal_code": "920642437",
            "telephone_number": "858-521-0031",
            "fax_number": "858-521-0921"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "POWAY CA MULTI SPECIALTY ASC LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-12-18",
        "last_updated": "2023-01-20",
        "certification_date": "2023-01-20",
        "status": "A",
        "authorized_official_last_name": "SNODGRASS",
        "authorized_official_first_name": "JEFFREY",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "615-665-1283",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Poway Surgery Center",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Poway Surgery Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Leilani Pompa
• Poplar Holdings, LLC (Poway Healthcare Center)
• Emily M Porcayo-Henriquez
• Mackenzie Potts
• Poway Adult Day Health Care Center LLC
• Poway Emergency Physicians, Inc
• Poway Gardens Memory Care LLC
• Poway Hospitalist Medical Group, Inc
• Poway Intensivist Medical Group, Inc
• Poway Medical Clinic, Incorporated

• Ambulatory Surgical Clinic/Center in Poway, CA
• Providers in Poway, 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 Jan 20, 2023; 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.