Excelsior Surgery Center

Primary specialty

Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X

Legal business name

EXCELSIOR SURGERY CENTER

Practice address

1320 El Capitan Drive
Danville, CA 94526-6260

Phone

(925) 676-2600

Fax

(925) 680-0212

NPI assigned

Oct 22, 2019

Last updated

Oct 22, 2019By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Murali Dharan, MDNPI 1336143882

Title

Owner/Cfo

Phone

(925) 676-2600

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1891338935. Details of each certification follow.

• CCN 05C0002274 Ambulatory surgical center · Active · Name & address match · Details

Ambulatory surgical center certification: CCN 05C0002274

Legal name

EXCELSIOR SURGERY CENTER LLC

Certification status

Active

Provider type (POS)

Ambulatory surgical center

Participating since

Jun 14, 2021

Last certification

Jun 14, 2021

Ownership / control type

Proprietary

Facility address

1320 El Capitan Dr Suite 120
Danville, CA 94526

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Practitioners 3

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.

• Shin Rong Lee, M.D., PH.D.

  • Vascular Surgery Physician
  • Concord, CA
  • NPI 1952789992
  Medicare reassignment NPD
• Murali Dharan, MD

  • Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
  • Danville, CA
  • NPI 1336143882
  NPD Authorized official
• Ramesh Sai Veeragandham, MD

  • Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
  • Danville, CA
  • NPI 1710972427
  NPD

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

{
    "created_epoch": "1571702400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1571702400000",
    "number": "1891338935",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1320 EL CAPITAN DRIVE",
            "city": "DANVILLE",
            "state": "CA",
            "postal_code": "945266260",
            "telephone_number": "925-676-2600",
            "fax_number": "925-680-0212"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1320 EL CAPITAN DRIVE",
            "city": "DANVILLE",
            "state": "CA",
            "postal_code": "945266260",
            "telephone_number": "925-676-2600",
            "fax_number": "925-680-0212"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EXCELSIOR SURGERY CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-10-22",
        "last_updated": "2019-10-22",
        "status": "A",
        "authorized_official_last_name": "DHARAN",
        "authorized_official_first_name": "MURALI",
        "authorized_official_title_or_position": "OWNER/CFO",
        "authorized_official_telephone_number": "925-676-2600",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Estee Goren, Marriage Counseling and Family Therapy, Inc.
• Cristal Anne Lorenzo Estrella
• Margo Estrin, M.D.
• Evolve Growth Initiatives LLC
• Evolve Growth Initiatives LLC (Evolve Treatment Center, Danville)
• Executive Gi Services (Executive GI Services, Inc.)
• Executive Surgery Center, Inc.
• F. Ryan Anderson, MD (F. Ryan Anderson M.D. Inc)
• Lisa Faer
• Clarissa Fago, FNP

• Ambulatory Surgical Clinic/Center in Danville, CA
• Providers in Danville, 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 Oct 22, 2019; 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.

Verify at the official NPI Registry.