NPIMap

Organization Active NPI

Scripps Encinitas Surgery Center, LLC

  • Ambulatory Surgical Clinic/Center
  • Encinitas, CA
National Provider Identifier
1821112145
Registry record updated Sep 5, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X
Legal business name
SCRIPPS ENCINITAS SURGERY CENTER, LLC
Practice address
320 Santa Fe Dr
Ste LL2
Encinitas, CA 92024-5138
Phone
(760) 632-3900
Fax
(760) 362-3950
NPI assigned
Mar 19, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 5, 2024

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

Authorized official

Name
Eric Boon
Title
Authorized Official
Phone
(480) 567-0269

Specialties & licenses 1

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

Addresses

Primary practice location

320 Santa Fe Dr
Ste LL2
Encinitas, CA 92024-5138

Mailing address

320 Santa Fe Dr
Ste LL2
Encinitas, CA 92024-5138
Phone (760) 632-3900

Other identifiers 1

IdentifierTypeStateIssuer
P00726468OtherCARAILROAD MEDICARE

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL https://esmd.abilitynetwork.com:8291/gateway/documentsubmission/2_0/NhinService/XDRRequest_Service Other Ability Network

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20040524001507 CA Part B Supplier - Clinic/Group Practice 0143201442 Receives reassigned benefits from 28 practitioners
7 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Encinitas, CA; San Diego, CA; Oceanside, CA; Escondido, CA; Carlsbad, CA
O20080717000538 CA Part B Supplier - Ambulatory Surgical Center 9436222817 Practice locations: Encinitas, CA

Other NPIs on the same Medicare enrollment 7

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

Care Compare: Ambulatory surgical center

Medicare Care Compare
Listed as
Scripps Encinitas Surgery Center LLCCCN 05C0001842
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
05D0971259Scripps Surgery Center-Encinitas320 Santa Fe Drive Ste LL2, Encinitas, CA 92024Certificate of waiverMar 7, 2028
05D1071649Scripps Encinitas Surgery Center320 Santa Fe Dr LL2, Encinitas, CA 92024Certificate of waiverJul 29, 2027

National Provider Directory

National Provider Directory

Member of 3

Organizations this organization is a member of, according to the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 3

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": "1174262400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1725494400000",
    "number": "1821112145",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "320 SANTA FE DR",
            "address_2": "STE LL2",
            "city": "ENCINITAS",
            "state": "CA",
            "postal_code": "920245138",
            "telephone_number": "760-632-3900",
            "fax_number": "760-362-3950"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "320 SANTA FE DR",
            "address_2": "STE LL2",
            "city": "ENCINITAS",
            "state": "CA",
            "postal_code": "920245138",
            "telephone_number": "760-632-3900",
            "fax_number": "760-362-3950"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SCRIPPS ENCINITAS SURGERY CENTER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-19",
        "last_updated": "2024-09-05",
        "certification_date": "2024-09-05",
        "status": "A",
        "authorized_official_last_name": "BOON",
        "authorized_official_first_name": "ERIC",
        "authorized_official_title_or_position": "AUTHORIZED OFFICIAL",
        "authorized_official_telephone_number": "480-567-0269"
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": "CA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00726468",
            "state": "CA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://esmd.abilitynetwork.com:8291/gateway/documentsubmission/2_0/NhinService/XDRRequest_Service",
            "affiliation": "Y",
            "endpointDescription": "2.16.840.1.113883.3.667.2",
            "affiliationName": "Ability Network",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "CMS esMD eMDR",
            "address_1": "100 N 6th St Ste 900A",
            "city": "Minneapolis",
            "state": "MN",
            "country_code": "US",
            "postal_code": "554031516",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Encinitas, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 5, 2024; 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.