Fremont Ambulatory Surgery Center, LP

Primary specialty

Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X

License

140000527 Issued in CA

Legal business name

FREMONT AMBULATORY SURGERY CENTER, LP

Practice address

39350 Civic Center Dr Suite 100
Fremont, CA 94538-2331

Phone

(510) 456-4600

Fax

(510) 794-6822

NPI assigned

Mar 10, 2006

Organization subpart

No

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

Authorized official

Name

Mr. John Mazoros

Title

Administrator

Phone

(510) 456-4650

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Listed as

Fremont Ambulatory Surgery Center LPCCN 55C0001053

Medicare certification status

ActiveFrom the Provider of Services file

Locations

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

{
    "created_epoch": "1141948800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1509580800000",
    "number": "1851369284",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "39350 CIVIC CENTER DR STE 280",
            "city": "FREMONT",
            "state": "CA",
            "postal_code": "945382331",
            "telephone_number": "510-456-4600",
            "fax_number": "510-456-4601"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "39350 CIVIC CENTER DR SUITE 100",
            "city": "FREMONT",
            "state": "CA",
            "postal_code": "945382331",
            "telephone_number": "510-456-4600",
            "fax_number": "510-794-6822"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FREMONT AMBULATORY SURGERY CENTER, LP",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-03-10",
        "last_updated": "2017-11-02",
        "status": "A",
        "authorized_official_last_name": "MAZOROS",
        "authorized_official_first_name": "JOHN",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "510-456-4650",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": "CA",
            "license": "140000527",
            "primary": true
        },
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": "CA",
            "license": "140000600",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "SUR51053F",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Amanda Ann Frederick
• Carl Fredrickson, DDS
• Freedom Hospice of the Bay LLC
• David R Freiheit, MD
• Fremont Ambulatory Surgery Center, L.P.
• Fremont Artificial Limb & Brace, Inc.
• Fremont ASC Partners, LLC
• Fremont Dental Care
• Fremont Dental Implant Care
• Fremont Dermatology Medical Office

• Ambulatory Surgical Clinic/Center in Fremont, CA
• Providers in Fremont, 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 Nov 2, 2017; 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.