SRS-Thousand Oaks

Primary specialty

End-Stage Renal Disease (ESRD) Treatment Clinic/CenterTaxonomy code 261QE0700X

Legal business name

SRS-THOUSAND OAKS

Doing business as

SRS-Thousand Oaks, LLC

Practice address

375 Rolling Oaks Dr
Thousand Oaks, CA 91361-1023

Phone

(615) 467-0140

Fax

(615) 259-0693

NPI assigned

Mar 4, 2022

Organization subpart

No

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

Authorized official

Name

Dr. Jerome Seymour Tannenbaum MD, M.D, PH.D., FACP

Title

Ceo

Phone

(615) 467-0140

Specialties & licenses 1

Addresses

Other names 1

• SRS-Thousand Oaks, LLC Doing business as

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Listed as

SRS-Thousand Oaks DialysisCCN 052873

Overall star rating

1.0 of 5

Ownership

Profit

Certified

Oct 26, 2001

Medicare certification status

ActiveFrom the Provider of Services file

Dialysis stations

15

Locations

Practitioners 1

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

• Jerome Seymour Tannenbaum, M.D., PH.D.

  • Nephrology Physician
  • Nashville, TN
  • NPI 1346485638
  NPD (past)

Affiliated clinicians 3

Clinicians who list this facility as an affiliation in Medicare Care Compare.

• Rakesh Malhotra, M.D., M.P.H.

  • Nephrology Physician
  • San Diego, CA
  • NPI 1326346818

  Dialysis facility

  Care Compare affiliation Name & address match
• Salah Sonbol, M.D.

  • Nephrology Physician
  • Thousand Oaks, CA
  • NPI 1922008119

  Dialysis facility

  Care Compare affiliation Name & address match
• Jie Shi Yan, M.D.

  • Nephrology Physician
  • Simi Valley, CA
  • NPI 1396744546

  Dialysis facility

  Care Compare affiliation Name & address match

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

{
    "created_epoch": "1646352000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1702339200000",
    "number": "1912654468",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4230 HARDING PIKE STE 205",
            "city": "NASHVILLE",
            "state": "TN",
            "postal_code": "372052098",
            "telephone_number": "615-467-0140"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "375 ROLLING OAKS DR",
            "city": "THOUSAND OAKS",
            "state": "CA",
            "postal_code": "913611023",
            "telephone_number": "615-467-0140",
            "fax_number": "615-259-0693"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SRS-THOUSAND OAKS",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-03-04",
        "last_updated": "2023-12-12",
        "certification_date": "2023-12-12",
        "status": "A",
        "authorized_official_last_name": "TANNENBAUM MD",
        "authorized_official_first_name": "JEROME",
        "authorized_official_middle_name": "SEYMOUR",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "615-467-0140",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D, PH.D., FACP"
    },
    "taxonomies": [
        {
            "code": "261QE0700X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, End-Stage Renal Disease (ESRD) Treatment",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "SRS-Thousand Oaks, LLC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• End-Stage Renal Disease (ESRD) Treatment Clinic/Center in Thousand Oaks, CA
• Providers in Thousand Oaks, CA by specialty
• End-Stage Renal Disease (ESRD) Treatment Clinic/Center in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 12, 2023; 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.