Organization Active NPI

MC Surgical LLC

  • Nurse Practitioner
  • Soquel, CA
National Provider Identifier
1831952779
Registry record updated Feb 2, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
Legal business name
MC SURGICAL LLC
Practice address
4459 Hilltop Rd
Soquel, CA 95073-2310
Phone
(831) 818-4721
NPI assigned
Feb 2, 2024
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 2, 2024

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

Authorized official

Name
Melissa Joy Clay, NPNPI 1881894236
Title
Ceo
Phone
(831) 818-4721

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
Registered Nurse First AssistantGroup: 193200000X MULTI-SPECIALTY GROUP 163WR0006X
Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363L00000X Primary

Addresses

Primary practice location

4459 Hilltop Rd
Soquel, CA 95073-2310

Mailing address

4459 Hilltop Rd
Soquel, CA 95073-2310
Phone (831) 818-4721

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20240415003996 CA Part B Supplier - Clinic/Group Practice 1254770829 Receives reassigned benefits from 1 practitioner
Practice locations: Los Gatos, CA; San Jose, CA; Soquel, CA

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": "1706832000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1706832000000",
    "number": "1831952779",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4459 HILLTOP RD",
            "city": "SOQUEL",
            "state": "CA",
            "postal_code": "950732310",
            "telephone_number": "831-818-4721"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4459 HILLTOP RD",
            "city": "SOQUEL",
            "state": "CA",
            "postal_code": "950732310",
            "telephone_number": "831-818-4721"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MC SURGICAL LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-02-02",
        "last_updated": "2024-02-02",
        "certification_date": "2024-02-02",
        "status": "A",
        "authorized_official_last_name": "CLAY",
        "authorized_official_first_name": "MELISSA",
        "authorized_official_middle_name": "JOY",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "831-818-4721",
        "authorized_official_credential": "NP"
    },
    "taxonomies": [
        {
            "code": "163WR0006X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Registered Nurse, Registered Nurse First Assistant",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Soquel, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 2, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.