St. Joseph'S Surgery Center LP

Primary specialty

Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X

License

EXEMPT FROM LICENSUR Issued in CA

Legal business name

ST. JOSEPH'S SURGERY CENTER LP

Practice address

1800 N California St
Ste 1
Stockton, CA 95204-6019

Phone

(209) 467-6316

Fax

(209) 461-6895

NPI assigned

Jun 28, 2005

Organization subpart

No

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

Authorized official

Name

Eric Boon

Title

Authorized Official

Phone

(480) 567-0269

Specialties & licenses 1

Addresses

Other identifiers 3

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Listed as

St Josephs Surgery CenterCCN 05C0001711

Medicare certification status

ActiveFrom the Provider of Services file

Member of 4

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

• Port City Operating Company, LLC

  • Home Health Agency
  • Stockton, CA
  • NPI 1306978945

  Member Of

  NPD member
• Baylor University Medical Center

  • General Acute Care Hospital
  • Dallas, TX
  • NPI 1447250253

  Member Of

  NPD member
• Dignity Health

  • Neurological Surgery Physician
  • Henderson, NV
  • NPI 1720358039

  Member Of

  NPD member
• VHS San Antonio Partners LLC

  • Psychiatric Hospital Unit
  • San Antonio, TX
  • NPI 1487633509

  Member Of

  NPD member

Practitioners 1

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

• Victoria Jui-Yun Hsu, M.D.

  • Ophthalmology Physician
  • Manteca, CA
  • NPI 1295930527
  NPD (past)

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

{
    "created_epoch": "1119916800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1729641600000",
    "number": "1619974219",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1800 N CALIFORNIA ST",
            "address_2": "STE 1",
            "city": "STOCKTON",
            "state": "CA",
            "postal_code": "952046019",
            "telephone_number": "209-467-6316",
            "fax_number": "209-461-6895"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1800 N CALIFORNIA ST",
            "address_2": "STE 1",
            "city": "STOCKTON",
            "state": "CA",
            "postal_code": "952046019",
            "telephone_number": "209-467-6316",
            "fax_number": "209-461-6895"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ST. JOSEPH'S SURGERY CENTER LP",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-06-28",
        "last_updated": "2024-10-23",
        "certification_date": "2024-10-23",
        "status": "A",
        "authorized_official_last_name": "BOON",
        "authorized_official_first_name": "ERIC",
        "authorized_official_title_or_position": "AUTHORIZED OFFICIAL",
        "authorized_official_telephone_number": "480-567-0269"
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": "CA",
            "license": "EXEMPT FROM LICENSUR",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RAILROAD CARRIER",
            "identifier": "P00215810",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "05-C0001711",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MISC",
            "identifier": "CA0300001807",
            "state": "CA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://esmd.abilitynetwork.com:8291/gateway/documentsubmission/2_0/NhinService/XDRRequest_Service",
            "affiliation": "Y",
            "endpointDescription": "2.16.840.1.113883.3.667.2",
            "affiliationName": "Ability Network",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "address_1": "100 N 6th St Ste 900A",
            "city": "Minneapolis",
            "state": "MN",
            "country_code": "US",
            "postal_code": "554031516",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Shikha Srivastava
• Jacqueline St. James
• Seneca Oliver St. James
• Glenn Alexander St. John, RAS
• St. Joseph'S Medical Center
• St. Mary'S Dining Room
• St. Mary'S Urgent Care
• St. Rita Care Home
• St.Josephs Medical Associates Inc.
• Patricia Jean Stacy, NONE

• Ambulatory Surgical Clinic/Center in Stockton, CA
• Providers in Stockton, 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 23, 2024; 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.