Directed Interventional Surgery Ctr Inc a Professional Medical Corp

Primary specialty

Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X

License

S051520 Issued in CA

Legal business name

DIRECTED INTERVENTIONAL SURGERY CTR INC A PROFESSIONAL MEDICAL CORP

Practice address

2827 Wilshire Blvd
Santa Monica, CA 90403-4801

Phone

(310) 829-9788

Fax

(310) 453-1576

NPI assigned

Apr 2, 2007

Organization subpart

No

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

Authorized official

Name

Sally Case

Title

Billing Manager

Phone

(310) 829-9788

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Directed Interventional Surgery Center Former legal business name

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Ambulatory surgical center certification: CCN 05C0001520

Legal name

DIRECTED INTERVENTATIONAL SURG

Certification status

Active

Provider type (POS)

Ambulatory surgical center

Participating since

Jul 3, 2001

Last certification

Jul 10, 2018

Ownership / control type

Proprietary

Facility address

2827 Wilshire Blvd
Santa Monica, CA 90403

Practitioners 2

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

• Omid Jafari, MD

  • Diagnostic Radiology Physician
  • Santa Monica, CA
  • NPI 1639409139
  Medicare reassignment NPD
• Bradley A Jabour, M.D.

  • Neuroradiology Physician
  • Santa Monica, CA
  • NPI 1609997402
  NPD (past)

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

{
    "created_epoch": "1175472000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1486080000000",
    "number": "1679694392",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2827 WILSHIRE BLVD",
            "city": "SANTA MONICA",
            "state": "CA",
            "postal_code": "90403",
            "telephone_number": "310-829-9788",
            "fax_number": "310-453-1576"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2827 WILSHIRE BLVD",
            "city": "SANTA MONICA",
            "state": "CA",
            "postal_code": "904034801",
            "telephone_number": "310-829-9788",
            "fax_number": "310-453-1576"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DIRECTED INTERVENTIONAL SURGERY CTR INC A PROFESSIONAL MEDICAL CORP",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-02",
        "last_updated": "2017-02-03",
        "status": "A",
        "authorized_official_last_name": "CASE",
        "authorized_official_first_name": "SALLY",
        "authorized_official_title_or_position": "BILLING MANAGER",
        "authorized_official_telephone_number": "310-829-9788"
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": "CA",
            "license": "S051520",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GR0070730",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Directed Interventional Surgery Center",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

• Dino T. Deconcini MD Inc
• Melissa Ann Dinolfo, PHARM.D.
• Carrie Dinow
• Sydney Diop
• Direct Diagnostic Labs LLC
• Diane Michelle Dirks, CNM
• Danielle Dishmon, PHARMD
• Brian Edmund Diskin, M.D.
• Zenus Earl Dismukes
• Dixit Medical Inc

• Ambulatory Surgical Clinic/Center in Santa Monica, CA
• Providers in Santa Monica, 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 Feb 3, 2017; 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.