North State Surgery Centers, LP

Primary specialty

Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X

License

230000354 Issued in CA

Legal business name

NORTH STATE SURGERY CENTERS, LP

Doing business as

Mercy Surgery Center

Practice address

2175 Rosaline Ave
Ste a
Redding, CA 96001-2549

Phone

(530) 225-7400

Fax

(530) 225-7405

NPI assigned

Mar 12, 2008

Last updated

Oct 14, 2024By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Eric Boon

Title

Officer, Authorized Official

Phone

(480) 567-0269

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• Mercy Surgery Center Doing business as

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in CA2 enrollments

Enrollment records 2

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

• North State Surgery Centers LP

  dba Court Street Surgery Center

  • Ambulatory Surgical Clinic/Center
  • Redding, CA
  • NPI 1629249172

  8628964327

  Same PAC ID

Other NPIs on the same Medicare enrollment 2

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

• Mercy Surgery Center, LP

  • Ambulatory Surgical Clinic/Center
  • Redding, CA
  • NPI 1932102498

  O20040227000228

  Same enrollment
• North State Surgery Centers LP

  dba Court Street Surgery Center

  • Ambulatory Surgical Clinic/Center
  • Redding, CA
  • NPI 1629249172

  O20040227000228, O20170907000503

  Same enrollment

Listed as

North State Surgery Centers Dba Mercy Surgery CenterCCN 05C0001643

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

Tax ID family

Ability Network2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• North State Surgery Centers LP

  dba Court Street Surgery Center

  • Ambulatory Surgical Clinic/Center
  • Redding, CA
  • NPI 1629249172
  NPD tax ID

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Daniel Bruce Lensink, MD

  • Ophthalmology Physician
  • Redding, CA
  • NPI 1235124835
  NPD (past)

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

{
    "created_epoch": "1205280000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1728864000000",
    "number": "1700057254",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2175 ROSALINE AVE",
            "address_2": "STE A",
            "city": "REDDING",
            "state": "CA",
            "postal_code": "960012549",
            "telephone_number": "530-225-7400",
            "fax_number": "530-225-7405"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2175 ROSALINE AVE",
            "address_2": "STE A",
            "city": "REDDING",
            "state": "CA",
            "postal_code": "960012549",
            "telephone_number": "530-225-7400",
            "fax_number": "530-225-7405"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTH STATE SURGERY CENTERS, LP",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-03-12",
        "last_updated": "2024-10-14",
        "certification_date": "2024-10-14",
        "status": "A",
        "authorized_official_last_name": "BOON",
        "authorized_official_first_name": "ERIC",
        "authorized_official_title_or_position": "OFFICER, AUTHORIZED OFFICIAL",
        "authorized_official_telephone_number": "480-567-0269"
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": "CA",
            "license": "230000354",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00094713",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "SUR01643F",
            "state": "CA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://esmd.abilitynetwork.com:8291/gateway/documentsubmission/2_0/NhinService/XDRRequest_Service",
            "affiliation": "Y",
            "endpointDescription": "2.16.840.1.113883.3.667.2",
            "affiliationName": "Ability Network",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "CMS esMD eMDR",
            "address_1": "100 N 6th St Ste 900A",
            "city": "Minneapolis",
            "state": "MN",
            "country_code": "US",
            "postal_code": "554031516",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Mercy Surgery Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Ambulatory Surgical Clinic/Center in Redding, CA
• Providers in Redding, 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 14, 2024; 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.