Eos Wellness Surgery Center LLC

Primary specialty

Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X

License

A112498 Issued in CA

Legal business name

EOS WELLNESS SURGERY CENTER LLC

Practice address

8641 Wilshire Blvd Ste 305
Beverly Hills, CA 90211-2921

Phone

(310) 730-1218

Fax

(310) 861-1053

NPI assigned

Apr 25, 2018

Organization subpart

No

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

Authorized official

Name

Luana Farrar

Title

Accreditation Coordinator

Phone

(949) 337-3267

Specialties & licenses 1

Addresses

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 1801384987. Details of each certification follow.

• CCN 05C0002230 Ambulatory surgical center · Active · Name & address match · Details

Ambulatory surgical center certification: CCN 05C0002230

Legal name

EOS WELLNESS SURGERY CENTER LLC

Certification status

Active

Provider type (POS)

Ambulatory surgical center

Participating since

May 31, 2019

Last certification

May 31, 2019

Ownership / control type

Proprietary

Facility address

8641 Wilshire Blvd, Suite 305
Beverly Hills, CA 90211

Practitioners 1

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.

• Nima L Shemirani, M.D.

  • Facial Plastic Surgery Physician
  • Beverly Hills, CA
  • NPI 1154402287
  NPD (past)

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

{
    "created_epoch": "1524614400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1524614400000",
    "number": "1801384987",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8641 WILSHIRE BLVD STE 305",
            "city": "BEVERLY HILLS",
            "state": "CA",
            "postal_code": "902112921",
            "telephone_number": "310-730-1218",
            "fax_number": "310-861-1053"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8641 WILSHIRE BLVD STE 305",
            "city": "BEVERLY HILLS",
            "state": "CA",
            "postal_code": "902112921",
            "telephone_number": "310-730-1218",
            "fax_number": "310-861-1053"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EOS WELLNESS SURGERY CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-04-25",
        "last_updated": "2018-04-25",
        "status": "A",
        "authorized_official_last_name": "FARRAR",
        "authorized_official_first_name": "LUANA",
        "authorized_official_title_or_position": "ACCREDITATION COORDINATOR",
        "authorized_official_telephone_number": "949-337-3267"
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": "CA",
            "license": "A112498",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Alan David Engelberg, MD
• Matthew Joseph Enna, M.D.
• Abilene Alhambra Enriquez, M.D.
• ENT Senior Care Services Inc.
• Entertainment Medical Group Inc
• Freddie Mitchell Ephraim, MASSAGE THERAPIST
• Stuart Zane Epstein, MD
• Eraj Basseri MD a Professional Medical Corporation
• Eric a Lewis a Medical Corporation
• Ashley Ann Erickson

• Ambulatory Surgical Clinic/Center in Beverly Hills, CA
• Providers in Beverly Hills, 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 Apr 25, 2018; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.