NPIMap

Organization Active NPI

Upland Outpatient Surgery Center LP

Doing business as Ontario Advanced Surgery Center

  • Ambulatory Surgical Clinic/Center
  • Ontario, CA
National Provider Identifier
1710945787
Registry record updated Jul 10, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X
Legal business name
UPLAND OUTPATIENT SURGERY CENTER LP
Doing business as
Ontario Advanced Surgery Center
Practice address
1211 W 6TH St
Ontario, CA 91762-1103
Phone
(909) 981-8755
NPI assigned
May 1, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 10, 2019

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

Authorized official

Name
Venice Brinkman
Title
Chief Administrative Officer
Phone
(909) 981-8755

Specialties & licenses 1

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

Addresses

Primary practice location

1211 W 6TH St
Ontario, CA 91762-1103

Mailing address

1211 W 6TH St
Ontario, CA 91762-1103
Phone (909) 981-8755

Other practice location 1

1330 San Bernardino Rd
Suite F
Upland, CA 91786-4928
Phone (909) 981-8755

Other names 1

  • Ontario Advanced Surgery Center Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA3 enrollments

Enrollment records 3

Enrollment IDStateProvider typePAC IDDetails
O20050512001057 CA Part B Supplier - Ambulatory Surgical Center 4981645660 Practice locations: Ontario, CA
O20161101002657 CA Part B Supplier - Clinic/Group Practice 4082992623 Receives reassigned benefits from 49 practitioners
6 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Upland, CA; Victorville, CA; San Dimas, CA; San Bernardino, CA; Pomona, CA; Banning, CA; Loma Linda, CA; Riverside, CA…
O20161107000697 CA Part B Supplier - Clinic/Group Practice 0345528717 Receives reassigned benefits from 4 practitioners
2 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Ontario, CA; Rancho Cucamonga, CA

Other NPIs on the same Medicare enrollment 8

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

Care Compare: Ambulatory surgical center

Medicare Care Compare
Listed as
Upland Outpatient Surgery Center LPCCN 05C0001022
Medicare certification status
ActiveFrom the Provider of Services file

National Provider Directory

National Provider Directory

Member of 2

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

Practitioners & affiliated clinicians

Practitioners 2

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": "1146441600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1562716800000",
    "number": "1710945787",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1211 W 6TH ST",
            "city": "ONTARIO",
            "state": "CA",
            "postal_code": "917621103",
            "telephone_number": "909-981-8755"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1211 W 6TH ST",
            "city": "ONTARIO",
            "state": "CA",
            "postal_code": "917621103",
            "telephone_number": "909-981-8755"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1330 San Bernardino Rd",
            "address_2": "Suite F",
            "address_purpose": "LOCATION",
            "city": "Upland",
            "state": "CA",
            "postal_code": "917864928",
            "country_code": "US",
            "telephone_number": "909-981-8755",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "UPLAND OUTPATIENT SURGERY CENTER LP",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-01",
        "last_updated": "2019-07-10",
        "status": "A",
        "authorized_official_last_name": "BRINKMAN",
        "authorized_official_first_name": "VENICE",
        "authorized_official_title_or_position": "CHIEF ADMINISTRATIVE OFFICER",
        "authorized_official_telephone_number": "909-981-8755"
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Ontario Advanced Surgery Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Ontario, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 10, 2019; 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.