NPIMap

Organization Active NPI

Peninsula Surgical Specialist Medical Group, Inc.

  • Surgical Technologist
  • Burlingame, CA
National Provider Identifier
1720176225
Registry record updated Mar 10, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical TechnologistTaxonomy code 246ZS0410X
Legal business name
PENINSULA SURGICAL SPECIALIST MEDICAL GROUP, INC.
Practice address
1720 El Camino Real
Suite 101
Burlingame, CA 94010-3224
Phone
(650) 652-0600
NPI assigned
Oct 10, 2006
Organization subpart
Yes
Parent organization
SURGICAL ASSOCIATES OF THE PENINSULAAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Mar 10, 2008

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

Authorized official

Name
Dr. Dirk Baumann, M.D.NPI 1013058122
Title
Cfo
Phone
(650) 777-4064

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical TechnologistGroup: 193200000X MULTI-SPECIALTY GROUP 246ZS0410X Primary

Addresses

Primary practice location

1720 El Camino Real
Suite 101
Burlingame, CA 94010-3224

Mailing address

1720 El Camino Real
Suite 101
Burlingame, CA 94010-3224
Phone (650) 652-0600

Other identifiers 4

IdentifierTypeStateIssuer
CG1015OtherCARAILROAD MEDICARE
P00411831OtherCARAILROAD MEDICARE
P00431764OtherCARAILROAD MEDICARE
P00405374OtherCARAILROAD MEDICARE

Other names 1

  • Surgical Associates of the Peninsula A Medical Group, Inc. Doing business as

National Provider Directory

National Provider Directory
Part of
Peninsula Surgical Spec

Locations

1720 El Camino Real
Ste 101
Burlingame, CA 94010
Phone (650) 240-8000

1720 El Camino Real
Ste 125
Burlingame, CA 94010
Phone (650) 652-0600

Practitioners & affiliated clinicians

Practitioners 10

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": "1160438400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1205107200000",
    "number": "1720176225",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1720 EL CAMINO REAL",
            "address_2": "SUITE 101",
            "city": "BURLINGAME",
            "state": "CA",
            "postal_code": "940103224",
            "telephone_number": "650-652-0600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1720 EL CAMINO REAL",
            "address_2": "SUITE 101",
            "city": "BURLINGAME",
            "state": "CA",
            "postal_code": "940103224",
            "telephone_number": "650-652-0600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PENINSULA SURGICAL SPECIALIST MEDICAL GROUP, INC.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "SURGICAL ASSOCIATES OF THE PENINSULA",
        "enumeration_date": "2006-10-10",
        "last_updated": "2008-03-10",
        "status": "A",
        "authorized_official_last_name": "BAUMANN",
        "authorized_official_first_name": "DIRK",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "650-777-4064",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "246ZS0410X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Specialist/Technologist, Other, Surgical Technologist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "CG1015",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00411831",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00431764",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00405374",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Surgical Associates of the Peninsula A Medical Group, Inc.",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Burlingame, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 10, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.