Organization Active NPI

Simi Valley Surgery Center Inc

  • Ambulatory Surgical Clinic/Center
  • Simi Valley, CA
National Provider Identifier
1649893934
Registry record updated May 21, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X
Legal business name
SIMI VALLEY SURGERY CENTER INC
Doing business as
Simi Valley Surgery Center Inc
Practice address
3605 Alamo St Ste 102
Simi Valley, CA 93063-2186
Phone
(310) 674-0144
Fax
(310) 693-9845
NPI assigned
May 21, 2020
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 21, 2020

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

Authorized official

Name
Dr. Adebambo OjuriNPI 1679644983
Title
Medical Director
Phone
(310) 674-0144

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

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

Addresses

Primary practice location

3605 Alamo St Ste 102
Simi Valley, CA 93063-2186

Mailing address

8110 Airport Blvd
Los Angeles, CA 90045-3119
Phone (310) 674-0144

Other names 1

  • SIMI VALLEY SURGERY CENTER INC Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20200812001039 CA Part B Supplier - Ambulatory Surgical Center 4082030788 Practice locations: Simi Valley, CA

Care Compare: Ambulatory surgical center

Medicare Care Compare
Listed as
Simi Valley Surgery Center IncCCN 05C0002287
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": "1590019200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1590019200000",
    "number": "1649893934",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8110 AIRPORT BLVD",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900453119",
            "telephone_number": "310-674-0144",
            "fax_number": "310-693-9845"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3605 ALAMO ST STE 102",
            "city": "SIMI VALLEY",
            "state": "CA",
            "postal_code": "930632186",
            "telephone_number": "310-674-0144",
            "fax_number": "310-693-9845"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SIMI VALLEY SURGERY CENTER INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-05-21",
        "last_updated": "2020-05-21",
        "certification_date": "2020-05-21",
        "status": "A",
        "authorized_official_last_name": "OJURI",
        "authorized_official_first_name": "ADEBAMBO",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "310-674-0144",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "SIMI VALLEY SURGERY CENTER INC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Simi Valley, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 21, 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.