Corona Outpatient Surgicenter, LLC

Primary specialty

Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X

Legal business name

CORONA OUTPATIENT SURGICENTER, LLC

Practice address

1124 S Main St
# 101
Corona, CA 92882-4449

Phone

(951) 737-6363

Fax

(951) 272-6723

NPI assigned

Dec 31, 2008

Organization subpart

No

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

Authorized official

Name

Dr. Mark E Schneider, M.D.NPI 1134296767

Title

Owner/President

Phone

(951) 737-6363

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Ambulatory surgical center certification: CCN 05C0001925

Legal name

CORONA OUTPATIENT SURGICENTER, LLC

Certification status

Active

Provider type (POS)

Ambulatory surgical center

Participating since

Aug 17, 2009

Last certification

May 14, 2019

Ownership / control type

Proprietary

Facility address

1124 South Main Street, Suite 102
Corona, CA 92882

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Mark Edward Schneider, M.D.

  • Ophthalmology Physician
  • Corona, CA
  • NPI 1134296767
  NPD Authorized official

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

{
    "created_epoch": "1230681600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1230681600000",
    "number": "1902042658",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1124 S MAIN ST",
            "address_2": "# 101",
            "city": "CORONA",
            "state": "CA",
            "postal_code": "928824449",
            "telephone_number": "951-737-6363",
            "fax_number": "951-272-6723"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1124 S MAIN ST",
            "address_2": "# 101",
            "city": "CORONA",
            "state": "CA",
            "postal_code": "928824449",
            "telephone_number": "951-737-6363",
            "fax_number": "951-272-6723"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CORONA OUTPATIENT SURGICENTER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-12-31",
        "last_updated": "2008-12-31",
        "status": "A",
        "authorized_official_last_name": "SCHNEIDER",
        "authorized_official_first_name": "MARK",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "OWNER/PRESIDENT",
        "authorized_official_telephone_number": "951-737-6363",
        "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": []
}

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• Ambulatory Surgical Clinic/Center in Corona, CA
• Providers in Corona, 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 Dec 31, 2008; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.