Playa Advance Surgical Institute LLC

Primary specialty

Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X

Legal business name

PLAYA ADVANCE SURGICAL INSTITUTE LLC

Practice address

5450 Lincoln Blvd
Los Angeles, CA 90094-2002

Phone

(310) 600-5846

NPI assigned

Oct 15, 2012

Organization subpart

No

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

Authorized official

Name

Ms. Gladys Anne Happer, NPNPI 1912160623

Title

Managing Member

Phone

(310) 600-5846

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Ambulatory surgical center certification: CCN 05C0002044

Legal name

PLAYA ADVANCE SURGICAL INSTITUTE

Certification status

Active

Provider type (POS)

Ambulatory surgical center

Participating since

Dec 19, 2013

Last certification

Dec 16, 2016

Ownership / control type

Proprietary

Facility address

5450 Lincoln Blvd
Los Angeles, CA 90094

Locations

Practitioners 1

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

• Gladys Anne Happer, NP

  • Family Nurse Practitioner
  • Beverly Hills, CA
  • NPI 1912160623
  NPD Authorized official

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

{
    "created_epoch": "1350259200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1350259200000",
    "number": "1659624682",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4712 ADMIRALTY WAY",
            "address_2": "#930",
            "city": "MARINA DEL REY",
            "state": "CA",
            "postal_code": "902926905",
            "telephone_number": "310-600-5846"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5450 LINCOLN BLVD",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900942002",
            "telephone_number": "310-600-5846"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PLAYA ADVANCE SURGICAL INSTITUTE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-10-15",
        "last_updated": "2012-10-15",
        "status": "A",
        "authorized_official_last_name": "HAPPER",
        "authorized_official_first_name": "GLADYS",
        "authorized_official_middle_name": "ANNE",
        "authorized_official_title_or_position": "MANAGING MEMBER",
        "authorized_official_telephone_number": "310-600-5846",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "NP"
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Ambulatory Surgical Clinic/Center in Los Angeles, CA
• Providers in Los Angeles, 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 15, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.