Plaza Surgery Center L P

Primary specialty

Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X

License

050000578 Issued in CA

Legal business name

PLAZA SURGERY CENTER L P

Practice address

525 Plaza Dr
Suite 100
Santa Maria, CA 93454-6953

Phone

(805) 739-3809

Fax

(805) 739-3887

NPI assigned

Feb 28, 2007

Organization subpart

No

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

Authorized official

Name

Sue Andersen

Title

Cfo

Phone

(805) 739-3600

Specialties & licenses 1

Addresses

Other identifiers 5

Other names 1

• Plaza Surgery Center Other name

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Listed as

Plaza Surgery CenterCCN 05C0001620

Medicare certification status

ActiveFrom the Provider of Services file

Member of 1

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

• Dignity Health

  • Neurological Surgery Physician
  • Henderson, NV
  • NPI 1720358039

  Member Of

  NPD member

Locations

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

{
    "created_epoch": "1172620800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1771200000000",
    "number": "1740318153",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "525 PLAZA DR STE 100",
            "city": "SANTA MARIA",
            "state": "CA",
            "postal_code": "934546966",
            "telephone_number": "805-739-3809",
            "fax_number": "805-739-3887"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "525 PLAZA DR",
            "address_2": "SUITE 100",
            "city": "SANTA MARIA",
            "state": "CA",
            "postal_code": "934546953",
            "telephone_number": "805-739-3809",
            "fax_number": "805-739-3887"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PLAZA SURGERY CENTER L P",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-28",
        "last_updated": "2026-02-16",
        "certification_date": "2026-02-16",
        "status": "A",
        "authorized_official_last_name": "ANDERSEN",
        "authorized_official_first_name": "SUE",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "805-739-3600"
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": "CA",
            "license": "050000578",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "IRS - SP TAS ID",
            "identifier": "651190935",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "7498486",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "CGP171469",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD OF CA",
            "identifier": "ZZZH4213Z",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "SUR01620F",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Plaza Surgery Center",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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• Raul Poblano Alvarez, LCSW
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• Veronica Polyakova, DO
• Mark Ford Pomerantz, MD

• Ambulatory Surgical Clinic/Center in Santa Maria, CA
• Providers in Santa Maria, 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 Feb 16, 2026; 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.