Active NPI
Inland Outpatient Surgery Center, Inc.
- Ambulatory Surgical Clinic/Center
- Riverside, CA
National Provider Identifier
1861702359
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Ambulatory Surgical Clinic/Center
- Legal business name
- INLAND OUTPATIENT SURGERY CENTER, INC.
- Practice address
- 4217 Luther St
Riverside, CA 92506-2853 - Phone
- (951) 600-7702
- Fax
- (951) 600-5935
- NPI assigned
- Oct 18, 2010
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Dr. Andrew Thio, M.D.
- Title
- Medical Director
- Phone
- (951) 600-7702
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Ambulatory Surgical Clinic/Center | 261QA1903X | Primary |
Addresses
Primary practice location
4217 Luther St
Riverside, CA 92506-2853
Mailing address
41670 Ivy St
Suite B
Murrieta, CA 92562-9432
Phone (951) 600-7702
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CA
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20110215001190 | CA | Part B Supplier - Ambulatory Surgical Center | 0749460202 | Practice locations: Riverside, CA |
Ambulatory surgical center certification: CCN 05C0001732
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
- INLAND OUTPATIENT SURGERY CENTER
- Certification status
- Active
- Provider type (POS)
- Ambulatory surgical center
- Participating since
- May 13, 2005
- Last certification
- Dec 5, 2018
- Ownership / control type
- Proprietary
- Facility address
- 4217 Luther Street
Riverside, CA 92506
Laboratory certificates & supplier records
Derived by NPIMapThese CMS records do not include an NPI. They are shown because their name and street address match this provider’s.
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 05D2027651 | Inland Outpatient Surgery Center | Certificate of waiver | Jul 27, 2027 |
National Provider Directory
National Provider DirectoryNPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1287360000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1287360000000",
"number": "1861702359",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "41670 IVY ST",
"address_2": "SUITE B",
"city": "MURRIETA",
"state": "CA",
"postal_code": "925629432",
"telephone_number": "951-600-7702",
"fax_number": "951-600-5935"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4217 LUTHER ST",
"city": "RIVERSIDE",
"state": "CA",
"postal_code": "925062853",
"telephone_number": "951-600-7702",
"fax_number": "951-600-5935"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "INLAND OUTPATIENT SURGERY CENTER, INC.",
"organizational_subpart": "NO",
"enumeration_date": "2010-10-18",
"last_updated": "2010-10-18",
"status": "A",
"authorized_official_last_name": "THIO",
"authorized_official_first_name": "ANDREW",
"authorized_official_title_or_position": "MEDICAL DIRECTOR",
"authorized_official_telephone_number": "951-600-7702",
"authorized_official_name_prefix": "Dr.",
"authorized_official_credential": "M.D."
},
"taxonomies": [
{
"code": "261QA1903X",
"taxonomy_group": "",
"desc": "Clinic/Center, Ambulatory Surgical",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Riverside, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 18, 2010; 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.
- 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.