Organization Active NPI

Trinity Surgery Center, LLC

  • Ambulatory Surgical Clinic/Center
  • San Jose, CA
National Provider Identifier
1750789814
Registry record updated Dec 5, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X
Legal business name
TRINITY SURGERY CENTER, LLC
Practice address
1610 Blossom Hill Rd
#13
San Jose, CA 95124-6349
Phone
(408) 528-8833
NPI assigned
Dec 5, 2014
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 5, 2014

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

Authorized official

Name
Dr. James Ptros, M.D.
Title
Medical Director
Phone
(408) 528-8833

Specialties & licenses 1

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

Addresses

Primary practice location

1610 Blossom Hill Rd
#13
San Jose, CA 95124-6349

Mailing address

1610 Blossom Hill Rd
#13
San Jose, CA 95124-6349
Phone (408) 528-8833

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20150519001511 CA Part B Supplier - Ambulatory Surgical Center 1254651060 Practice locations: San Jose, CA

Care Compare: Ambulatory surgical center

Medicare Care Compare
Listed as
Trinity Surgery Center LLCCCN 05C0002157
Medicare certification status
ActiveFrom the Provider of Services file

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
05D2103883Trinity Surgery Center, LLC1610 Blossom Hill Rd Ste 10, San Jose, CA 95124Certificate of waiverOct 21, 2027

National Provider Directory

National Provider Directory

Locations

1610 Blossom Hill Rd
Ste 13
San Jose, CA 95124
Phone (408) 528-8833

Practitioners & affiliated clinicians

Practitioners 2

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": "1417737600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1417737600000",
    "number": "1750789814",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1610 BLOSSOM HILL RD",
            "address_2": "#13",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951246349",
            "telephone_number": "408-528-8833"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1610 BLOSSOM HILL RD",
            "address_2": "#13",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951246349",
            "telephone_number": "408-528-8833"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TRINITY SURGERY CENTER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-12-05",
        "last_updated": "2014-12-05",
        "status": "A",
        "authorized_official_last_name": "PTROS",
        "authorized_official_first_name": "JAMES",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "408-528-8833",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Jose, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 5, 2014; 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.