Organization Active NPI

Select Surgical, a Medical Corporation

  • Anesthesiology Physician
  • Santa Monica, CA
National Provider Identifier
1912369703
Registry record updated Sep 15, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
Legal business name
SELECT SURGICAL, A MEDICAL CORPORATION
Practice address
1223 Wilshire Blvd Ste 594
Santa Monica, CA 90403-5406
Phone
(213) 935-8566
NPI assigned
Mar 22, 2016
Last updated
Sep 15, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 15, 2020

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

Authorized official

Name
Jennifer Hertz, MDNPI 1366771818
Title
President
Phone
(323) 445-6249

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
Anesthesiology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207L00000X Primary
Ambulatory Surgical Clinic/Center 261QA1903X

Addresses

Primary practice location

1223 Wilshire Blvd Ste 594
Santa Monica, CA 90403-5406

Mailing address

1223 Wilshire Blvd Ste 594
Santa Monica, CA 90403-5406
Phone (213) 935-8566

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20250512001295 CA Part B Supplier - Clinic/Group Practice 2365969466 Receives reassigned benefits from 2 practitioners
Practice locations: Los Angeles, CA

National Provider Directory

National Provider Directory

Locations

3617 Avalon Blvd
Ste 100
Los Angeles, CA 90011
Phone (213) 550-1201

Practitioners & affiliated clinicians

Practitioners 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1458604800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1600128000000",
    "number": "1912369703",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1223 WILSHIRE BLVD STE 594",
            "city": "SANTA MONICA",
            "state": "CA",
            "postal_code": "904035406",
            "telephone_number": "213-935-8566"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1223 WILSHIRE BLVD STE 594",
            "city": "SANTA MONICA",
            "state": "CA",
            "postal_code": "904035406",
            "telephone_number": "213-935-8566"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SELECT SURGICAL, A MEDICAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-03-22",
        "last_updated": "2020-09-15",
        "certification_date": "2020-09-15",
        "status": "A",
        "authorized_official_last_name": "HERTZ",
        "authorized_official_first_name": "JENNIFER",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "323-445-6249",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Anesthesiology",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Santa Monica, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 15, 2020; 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.