Presidio Surgery Center, LLC

Primary specialty

Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X

License

TBD Issued in CA

Legal business name

PRESIDIO SURGERY CENTER, LLC

Doing business as

Presidio Surgery Center

Practice address

1635 Divisadero St
Suite 200
San Francisco, CA 94115-3036

Phone

(415) 346-1218

NPI assigned

May 11, 2006

Last updated

Aug 22, 2020By 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

Ms. Jessie Scott, P.T., M.B.A.

Title

Manager

Phone

(415) 600-1484

Specialties & licenses 1

Addresses

Other names 1

• Presidio Surgery Center Doing business as

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Listed as

Presidio Surgery Center LLCCCN 05C0001772

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.

• Sutter Bay Hospitals

  • Critical Access Hospital
  • Lakeport, CA
  • NPI 1952634008

  Member Of

  NPD member

Practitioners 2

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.

• Cory T Hall, PAC

  • Physician Assistant
  • South Lake Tahoe, CA
  • NPI 1093706558
  NPD
• Ira D Sharlip, M.D.

  • Urology Physician
  • San Francisco, CA
  • NPI 1548362916
  NPD (past)

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

{
    "created_epoch": "1147305600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1609826361",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1635 DIVISADERO ST",
            "address_2": "SUITE 200",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941153036"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1635 DIVISADERO ST",
            "address_2": "SUITE 200",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941153036",
            "telephone_number": "415-346-1218"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRESIDIO SURGERY CENTER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-11",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "SCOTT",
        "authorized_official_first_name": "JESSIE",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "415-600-1484",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "P.T., M.B.A."
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": "CA",
            "license": "TBD",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Presidio Surgery Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Marie Carol President, M.D
• Presidio Dermatology, Inc
• Presidio Health Services, LLC (Presidio Health Services)
• Presidio Psychotherapy
• Presidio Sport & Medicine, Inc.
• Presidio Therapy Services, LLC (Presidio Therapy Services)
• Beverly Presley-Nelson, DDS
• Corinna N. Press, PSY.D.
• Jennifer Lynn Press, LMFT
• Jessica Press

• Ambulatory Surgical Clinic/Center in San Francisco, CA
• Providers in San Francisco, 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 Aug 22, 2020; 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.