National Surgical Centers Stockton, LLC

Primary specialty

Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X

Legal business name

NATIONAL SURGICAL CENTERS STOCKTON, LLC

Practice address

415 E Harding Way Ste E
Stockton, CA 95204-6118

Phone

(310) 919-9560

NPI assigned

Jun 25, 2020

Last updated

Jun 25, 2020By 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

Mrs. Diane L Boone, RN

Title

Chief Nursing Officer

Phone

(312) 919-9560

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 1922625995. Details of each certification follow.

• CCN 05C0002273 Ambulatory surgical center · Active · Name & address match · Details

Ambulatory surgical center certification: CCN 05C0002273

Legal name

NATIONAL SURGICAL CENTERS STOCKTON

Certification status

Active

Provider type (POS)

Ambulatory surgical center

Participating since

Jun 30, 2021

Last certification

Jun 30, 2021

Ownership / control type

Proprietary

Facility address

415 E Harding Way
Stockton, CA 95204

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 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.

• Atul T. Roy, M.D.

  • Nephrology Physician
  • Merced, CA
  • NPI 1467496505
  NPD
• Krishna Mohan Jain, M.D.

  • Vascular Surgery Physician
  • Kalamazoo, MI
  • NPI 1013972769
  NPD (past)

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

{
    "created_epoch": "1593043200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1593043200000",
    "number": "1922625995",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "561 WINDING BROOK FARM RD",
            "city": "WATERTOWN",
            "state": "CT",
            "postal_code": "067951747",
            "telephone_number": "310-919-9560"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "415 E HARDING WAY STE E",
            "city": "STOCKTON",
            "state": "CA",
            "postal_code": "952046118",
            "telephone_number": "310-919-9560"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NATIONAL SURGICAL CENTERS STOCKTON, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-06-25",
        "last_updated": "2020-06-25",
        "certification_date": "2020-06-25",
        "status": "A",
        "authorized_official_last_name": "BOONE",
        "authorized_official_first_name": "DIANE",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "CHIEF NURSING OFFICER",
        "authorized_official_telephone_number": "312-919-9560",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "RN"
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sheila Natali
• Gurushankar Natarajan
• Sundar Natarajan, M.D.
• Nathan a. Kludt, MD, Inc (Plastic Surgery Center of Stockton)
• National Seating & Mobility Inc
• National Vision Inc (America's Best Contacts & Eyeglasses)
• National Vision, Inc. (Eyeglass World)
• Nationwide Medical Group, Inc
• Johanna Natoza
• Kenneth Y Natsuhara, D.D.S.

• Ambulatory Surgical Clinic/Center in Stockton, CA
• Providers in Stockton, 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 Jun 25, 2020; 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.