Aesthetic Surgical Center of Santa Monica

Primary specialty

Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X

License

105461 Issued in CA

Legal business name

AESTHETIC SURGICAL CENTER OF SANTA MONICA

Practice address

1301 20TH St Ste 350
Santa Monica, CA 90404-2052

Phone

(310) 315-1121

Fax

(310) 315-9921

NPI assigned

Jan 23, 2007

Last updated

Jun 12, 2017By 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

Dr. Steven Alan Teitelbaum, M.D.NPI 1356471882

Title

Chief Executive Officer

Phone

(310) 315-1121

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1740335744. Details of each certification follow.

• CCN 05C0001485 Ambulatory surgical center · Active · Name & address match · Details

Ambulatory surgical center certification: CCN 05C0001485

Legal name

AESTHETIC SURGICAL CENTER OF SANTA MONICA

Certification status

Active

Provider type (POS)

Ambulatory surgical center

Participating since

Sep 25, 2000

Last certification

Feb 17, 2016

Ownership / control type

Proprietary

Facility address

1301 20TH Street, Suite 350
Santa Monica, CA 90404

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

CLIA laboratory certificates

Locations

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.

• Steven A. Teitelbaum

  • Plastic Surgery Physician
  • Santa Monica, CA
  • NPI 1356471882
  NPD (past) Authorized official
• Rita M. Moorman, M.D.

  • Anesthesiology Physician
  • Orange, CA
  • NPI 1699758128
  NPD (past)

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

{
    "created_epoch": "1169510400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1497225600000",
    "number": "1740335744",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1301 20TH ST STE 350",
            "city": "SANTA MONICA",
            "state": "CA",
            "postal_code": "904042052",
            "telephone_number": "310-315-1121",
            "fax_number": "310-315-9921"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1301 20TH ST STE 350",
            "city": "SANTA MONICA",
            "state": "CA",
            "postal_code": "904042052",
            "telephone_number": "310-315-1121",
            "fax_number": "310-315-9921"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AESTHETIC SURGICAL CENTER OF SANTA MONICA",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-23",
        "last_updated": "2017-06-12",
        "status": "A",
        "authorized_official_last_name": "TEITELBAUM",
        "authorized_official_first_name": "STEVEN",
        "authorized_official_middle_name": "ALAN",
        "authorized_official_title_or_position": "CHIEF EXECUTIVE OFFICER",
        "authorized_official_telephone_number": "310-315-1121",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": "CA",
            "license": "105461",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1740335744",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Advanced Surgical Associates of Santa Monica
• Advanced Therapy Surgery Center Inc
• Advanced Thermal Associates a Professional Corporation
• Aeg Medical Inc
• Hedwig Aerts
• David Aframian, MD
• Leora Aframian, RD
• Parviz D. Afshani, M.D.
• Asal Askarinam Aghajani
• Mehrdad Aghajani, NP

• Ambulatory Surgical Clinic/Center in Santa Monica, CA
• Providers in Santa Monica, 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 Jun 12, 2017; 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.