Organization Active NPI

Prime Surgical Center of Newport Beach, LLC

  • Ambulatory Surgical Clinic/Center
  • Newport Beach, CA
National Provider Identifier
1639610348
Registry record updated Jul 19, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X
Legal business name
PRIME SURGICAL CENTER OF NEWPORT BEACH, LLC
Practice address
351 Hospital Rd Ste 110
Newport Beach, CA 92663-3503
Phone
(949) 335-4966
NPI assigned
Mar 14, 2017
Organization subpart
Yes
Parent organization
PRIME SURGICAL AFFILIATESAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jul 19, 2022

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

Authorized official

Name
Caroline Singer
Title
Chief Executive Officer
Phone
(818) 937-9969

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ambulatory Surgical Clinic/Center 261QA1903X Primary

Addresses

Primary practice location

351 Hospital Rd Ste 110
Newport Beach, CA 92663-3503

Mailing address

550 N Brand Blvd Ste 900
Glendale, CA 91203-4721
Phone (818) 937-9969

Other practice location 1

130 N Brand Blvd
Suite 303
Glendale, CA 91203-2644
Phone (818) 937-9969

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20220701002396 CA Part B Supplier - Ambulatory Surgical Center 6305226754 Practice locations: Newport Beach, CA

Care Compare: Ambulatory surgical center

Medicare Care Compare
Listed as
Prime Surgical Center of Newport Beach LLCCCN 55C0001135
Medicare certification status
ActiveFrom the Provider of Services file

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1489449600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658188800000",
    "number": "1639610348",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "550 N BRAND BLVD STE 900",
            "city": "GLENDALE",
            "state": "CA",
            "postal_code": "912034721",
            "telephone_number": "818-937-9969"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "351 HOSPITAL RD STE 110",
            "city": "NEWPORT BEACH",
            "state": "CA",
            "postal_code": "926633503",
            "telephone_number": "949-335-4966"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "130 N Brand Blvd",
            "address_2": "Suite 303",
            "address_purpose": "LOCATION",
            "city": "Glendale",
            "state": "CA",
            "postal_code": "912032644",
            "country_code": "US",
            "telephone_number": "818-937-9969",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "PRIME SURGICAL CENTER OF NEWPORT BEACH, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "PRIME SURGICAL AFFILIATES",
        "enumeration_date": "2017-03-14",
        "last_updated": "2022-07-19",
        "certification_date": "2022-07-19",
        "status": "A",
        "authorized_official_last_name": "SINGER",
        "authorized_official_first_name": "CAROLINE",
        "authorized_official_title_or_position": "CHIEF EXECUTIVE OFFICER",
        "authorized_official_telephone_number": "818-937-9969"
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Newport Beach, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 19, 2022; 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.