Organization Active NPI

Aspen Surgery Center, LLC

  • Ambulatory Surgical Clinic/Center
  • Walnut Creek, CA
National Provider Identifier
1710177795
Registry record updated Feb 23, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X
Legal business name
ASPEN SURGERY CENTER, LLC
Practice address
133 La Casa Via Ste 150
Walnut Creek, CA 94598-3005
Phone
(925) 210-8400
Fax
(925) 947-3258
NPI assigned
Jul 26, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 23, 2023

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

Authorized official

Name
Jennifer Boyd Baldock
Title
Officer and Authorized Official
Phone
(615) 234-5954

Specialties & licenses 1

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

Addresses

Primary practice location

133 La Casa Via Ste 150
Walnut Creek, CA 94598-3005

Mailing address

133 La Casa Via
Walnut Creek, CA 94598
Phone (925) 947-3282

Other practice location 1

100 N Wiget Ln Ste 110
Walnut Creek, CA 94598-5909
Phone (925) 949-8784

Other names 1

  • Aspen Surgery Center Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20080524000021 CA Part B Supplier - Ambulatory Surgical Center 8325117823 Practice locations: Walnut Creek, CA

Care Compare: Ambulatory surgical center

Medicare Care Compare
Listed as
Aspen Surgery Center LLC Dba Aspen Surgery CenterCCN 05C0001830
Medicare certification status
ActiveFrom the Provider of Services file

Laboratory certificates & supplier records

Derived by NPIMap

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

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
05D1076006Aspen Surgery Center, LLC133 La Casa Via, Suite 150, Walnut Creek, CA 94598Certificate of waiverNov 1, 2027

National Provider Directory

National Provider Directory

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

Locations

133 La Casa Via
Ste 150
Walnut Creek, CA 94598
Phone (925) 210-8400

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": "1185408000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1677110400000",
    "number": "1710177795",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "133 LA CASA VIA",
            "city": "WALNUT CREEK",
            "state": "CA",
            "postal_code": "94598",
            "telephone_number": "925-947-3282",
            "fax_number": "925-947-3258"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "133 LA CASA VIA STE 150",
            "city": "WALNUT CREEK",
            "state": "CA",
            "postal_code": "945983005",
            "telephone_number": "925-210-8400",
            "fax_number": "925-947-3258"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "100 N Wiget Ln Ste 110",
            "address_purpose": "LOCATION",
            "city": "Walnut Creek",
            "state": "CA",
            "postal_code": "945985909",
            "country_code": "US",
            "telephone_number": "925-949-8784",
            "fax_number": "925-949-8762",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "ASPEN SURGERY CENTER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-07-26",
        "last_updated": "2023-02-23",
        "certification_date": "2023-02-23",
        "status": "A",
        "authorized_official_last_name": "BALDOCK",
        "authorized_official_first_name": "JENNIFER",
        "authorized_official_middle_name": "BOYD",
        "authorized_official_title_or_position": "OFFICER AND AUTHORIZED OFFICIAL",
        "authorized_official_telephone_number": "615-234-5954"
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Aspen Surgery Center",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Aspen Surgery Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Walnut Creek, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 23, 2023; 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.