J C Pitts Enterprises Inc

Primary specialty

Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X

License

071506ASC Issued in OR

Legal business name

J C PITTS ENTERPRISES INC

Doing business as

Ontario Surgery Center

Practice address

251 SW 19TH Street
Ontario, OR 97914-1972

Phone

(541) 889-3198

Fax

(208) 377-9455

NPI assigned

Nov 17, 2006

Last updated

Mar 4, 2025By 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

Jacob Mong, DONPI 1346535481

Title

Medical Director/Owner

Phone

(208) 377-3937

Specialties & licenses 1

Addresses

Other identifiers 7

Other names 1

• Ontario Surgery Center Doing business as

Medicare fee-for-service enrollment

Enrolled in OR

Enrollment records 1

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1730252487. Details of each certification follow.

• CCN 38C0001021 Ambulatory surgical center · Active · Name & address match · Details

Ambulatory surgical center certification: CCN 38C0001021

Legal name

Ontario Surgery Center

Certification status

Active

Provider type (POS)

Ambulatory surgical center

Participating since

Jul 19, 1996

Last certification

Sep 6, 2018

Ownership / control type

Proprietary

Facility address

251 SW 19th Street
Ontario, OR 97914

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

CLIA laboratory certificates

Practitioners 2

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.

• Jacob Adam Mong, D.O.

  • Ophthalmology Physician
  • Boise, ID
  • NPI 1346535481
  NPD Authorized official
• Jeffrey C Pitts, MD

  • Ophthalmology Physician
  • Ontario, OR
  • NPI 1477621662
  NPD

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

{
    "created_epoch": "1163721600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1741046400000",
    "number": "1730252487",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "251 SW 19TH STREET",
            "city": "ONTARIO",
            "state": "OR",
            "postal_code": "979141972",
            "telephone_number": "541-889-3198",
            "fax_number": "208-377-9455"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "251 SW 19TH STREET",
            "city": "ONTARIO",
            "state": "OR",
            "postal_code": "979141972",
            "telephone_number": "541-889-3198",
            "fax_number": "208-377-9455"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "J C PITTS ENTERPRISES INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-17",
        "last_updated": "2025-03-04",
        "certification_date": "2025-03-04",
        "status": "A",
        "authorized_official_last_name": "MONG",
        "authorized_official_first_name": "JACOB",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR/OWNER",
        "authorized_official_telephone_number": "208-377-3937",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": "OR",
            "license": "071506ASC",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD",
            "identifier": "000010019705",
            "state": "ID"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "003419300",
            "state": "ID"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS OREGON",
            "identifier": "100783000",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PACIFIC SOURCE",
            "identifier": "P051001",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "BMUY9",
            "state": "ID"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "135876",
            "state": "OR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "100783000",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Ontario Surgery Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Judy L Hymas
• Maureen Ireland, QMHA
• Iris Psychiatry
• Marc Munroe Iseri, MD
• Sylvia D Ixta, CHW
• Siri Jackman, NMNP-PP
• Jeffrey Jackson
• Kreyton Dirk Jackson, O.D.
• Melissa Jacobs, CADC
• David Jacobus

• Ambulatory Surgical Clinic/Center in Ontario, OR
• Providers in Ontario, OR by specialty
• Ambulatory Surgical Clinic/Center in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 4, 2025; 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.