Organization Active NPI

Sherman Oaks Surgery Center Inc. a Medical Corporation

  • Ambulatory Surgical Clinic/Center
  • Sherman Oaks, CA
National Provider Identifier
1790834612
Registry record updated Jun 10, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X
License
975-4776372 Issued in CA
Legal business name
SHERMAN OAKS SURGERY CENTER INC. A MEDICAL CORPORATION
Practice address
5170 Sepulveda Blvd
#140
Sherman Oaks, CA 91403-1171
Phone
(818) 728-4833
NPI assigned
Jan 9, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 10, 2016

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

Authorized official

Name
Dr. Aziz H Berjis, DPMNPI 1720163710
Title
Medical Director
Phone
(818) 995-8702

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Ambulatory Surgical Clinic/Center 261QA1903X 9300946 CA
Ambulatory Surgical Clinic/Center 261QA1903X 975-4776372 CA Primary

Addresses

Primary practice location

5170 Sepulveda Blvd
#140
Sherman Oaks, CA 91403-1171

Mailing address

5170 Sepulveda Blvd
Ste 140
Sherman Oaks, CA 91403
Phone (818) 995-8702

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20090721000600 CA Part B Supplier - Ambulatory Surgical Center 2062564156 Practice locations: Sherman Oaks, CA

Ambulatory surgical center certification: CCN 05C0001477

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
SHERMAN OAKS SURGERY CENTER
Certification status
Active
Provider type (POS)
Ambulatory surgical center
Participating since
Aug 22, 2000
Last certification
Mar 13, 2019
Ownership / control type
Proprietary
Facility address
5170 Sepulveda Blvd, Suite 140
Sherman Oaks, CA 91403

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
05D2210244Sherman Oaks Surgery Center5170 Sepulveda Blvd Ste 140, Sherman Oaks, CA 91403Certificate of waiverJan 19, 2027

National Provider Directory

National Provider Directory

Locations

5170 Sepulveda Blvd
Ste 140
Sherman Oaks, CA 91403
Phone (818) 728-4833

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": "1168300800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1465516800000",
    "number": "1790834612",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5170 SEPULVEDA BLVD",
            "address_2": "STE 140",
            "city": "SHERMAN OAKS",
            "state": "CA",
            "postal_code": "91403",
            "telephone_number": "818-995-8702",
            "fax_number": "818-995-8703"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5170 SEPULVEDA BLVD",
            "address_2": "#140",
            "city": "SHERMAN OAKS",
            "state": "CA",
            "postal_code": "914031171",
            "telephone_number": "818-728-4833"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SHERMAN OAKS SURGERY CENTER INC. A MEDICAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-09",
        "last_updated": "2016-06-10",
        "status": "A",
        "authorized_official_last_name": "BERJIS",
        "authorized_official_first_name": "AZIZ",
        "authorized_official_middle_name": "H",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "818-995-8702",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DPM"
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": "CA",
            "license": "9300946",
            "primary": false
        },
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": "CA",
            "license": "975-4776372",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sherman Oaks, CA

Sources for this page

Verify at the official NPI Registry.