Santa Monica Surgical Partners LLC

Primary specialty

Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X

License

PENDING

Legal business name

SANTA MONICA SURGICAL PARTNERS LLC

Doing business as

Surgery Center of the Pacific

Practice address

2121 Wilshire Blvd
Suite 201
Santa Monica, CA 90403-5720

Phone

(310) 576-7267

Fax

(310) 828-8626

NPI assigned

Oct 17, 2006

Organization subpart

No

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

Authorized official

Name

Marina Groysman

Title

Administrator

Phone

(310) 576-7267

Specialties & licenses 1

Addresses

Other names 1

• Surgery Center of the Pacific Doing business as

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Hospital certification: CCN 050835

Legal name

SURGERY CENTER OF THE PACIFIC

Certification status

Terminated Voluntary: merger or closure, Feb 16, 2021

Provider type (POS)

Hospital – Short-term

Participating since

Feb 15, 2021

Last certification

Feb 15, 2021

Beds

1

Ownership / control type

Private (for profit)

Facility address

2121 Wilshire Blvd, Suite 201
Santa Monica, CA 90403

Listed as

Santa Monica Surgical Partners LLC Dba Surgery Center of the PacificCCN 05C0001796

Medicare certification status

ActiveFrom the Provider of Services file

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Practitioners 1

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

• Bert R Mandelbaum, M.D.

  • Sports Medicine (Orthopaedic Surgery) Physician
  • Santa Monica, CA
  • NPI 1770673840
  NPD

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

{
    "created_epoch": "1161043200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1674172800000",
    "number": "1699855213",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2121 WILSHIRE BLVD STE 201",
            "city": "SANTA MONICA",
            "state": "CA",
            "postal_code": "904035742",
            "telephone_number": "310-576-7267",
            "fax_number": "855-898-4055"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2121 WILSHIRE BLVD",
            "address_2": "SUITE 201",
            "city": "SANTA MONICA",
            "state": "CA",
            "postal_code": "904035720",
            "telephone_number": "310-576-7267",
            "fax_number": "310-828-8626"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SANTA MONICA SURGICAL PARTNERS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-17",
        "last_updated": "2023-01-20",
        "certification_date": "2023-01-20",
        "status": "A",
        "authorized_official_last_name": "GROYSMAN",
        "authorized_official_first_name": "MARINA",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "310-576-7267"
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": null,
            "license": "PENDING",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Surgery Center of the Pacific",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Surgery Center of the Pacific",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Santa Monica Superior Acupuncture Clinic Inc.
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• Santa Monica Therapy, a Psychology Corporation
• Santa Monica Urgent Care, Inc
• Santa Monica Wellness Center Corp
• Santa Monica Wound Center Inc
• Santa Monica Young Men's Christian Association (Santa Monica Family YMCA)

• 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 Jan 20, 2023; 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.
• 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.