NPIMap

Organization Active NPI

Gold Med Surgery Center Inc.

  • Ambulatory Surgical Clinic/Center
  • Encino, CA
National Provider Identifier
1750673398
Registry record updated May 24, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X
Legal business name
GOLD MED SURGERY CENTER INC.
Practice address
16311 Ventura Blvd Ste 1010
Encino, CA 91436-4345
Phone
(818) 990-9080
Fax
(818) 990-9758
NPI assigned
May 13, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 24, 2011

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

Authorized official

Name
Kristina Kutsina
Title
Manager
Phone
(818) 990-9080

Specialties & licenses 1

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

Addresses

Primary practice location

16311 Ventura Blvd Ste 1010
Encino, CA 91436-4345

Mailing address

16311 Ventura Blvd Ste 1010
Encino, CA 91436-4345
Phone (818) 990-9080

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

Ambulatory surgical center certification: CCN 05C0001460

Name & address match This certification has no NPI in the Medicare enrollment files. CMS publishes enrollment files for six facility types only, so it was connected to this NPI by matching the name and address CMS publishes for it.

Legal name
GOLD MED SURGERY CENTER, INC
Certification status
Active
Provider type (POS)
Ambulatory surgical center
Participating since
Jan 19, 2000
Last certification
Mar 22, 2018
Ownership / control type
Proprietary
Facility address
16311 Ventura Blvd, Suite 1010
Encino, CA 91436

Laboratory certificates & supplier records

Derived by NPIMap

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

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
05D2131686Gold Med Surgery Center16311 Ventura Blvd Ste 1010, Encino, CA 91436Certificate of waiverJun 4, 2027

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

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": "1305244800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1306195200000",
    "number": "1750673398",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16311 VENTURA BLVD STE 1010",
            "city": "ENCINO",
            "state": "CA",
            "postal_code": "914364345",
            "telephone_number": "818-990-9080",
            "fax_number": "818-990-9758"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16311 VENTURA BLVD STE 1010",
            "city": "ENCINO",
            "state": "CA",
            "postal_code": "914364345",
            "telephone_number": "818-990-9080",
            "fax_number": "818-990-9758"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GOLD MED SURGERY CENTER INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-05-13",
        "last_updated": "2011-05-24",
        "status": "A",
        "authorized_official_last_name": "KUTSINA",
        "authorized_official_first_name": "KRISTINA",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "818-990-9080"
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": "CA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Encino, CA

Sources for this page

Verify at the official NPI Registry.