Keck Medicine of Usc Surgery Center, Pasadena - LLC

Primary specialty

Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X

Legal business name

KECK MEDICINE OF USC SURGERY CENTER, PASADENA - LLC

Practice address

590 S Fair Oaks Ave
Pasadena, CA 91105-2614

Phone

(323) 442-8747

NPI assigned

Oct 11, 2024

Organization subpart

Yes

Parent organization

KECK MEDICINE OF USC SURGERY CENTERS, LLCAs reported in NPPES

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

Authorized official

Name

Jeremy Church

Title

Cfo/Usc Care Medical Group, Inc.

Phone

(323) 442-8747

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Ambulatory surgical center certification: CCN 55C0001228

Legal name

Keck Medicine of USC Surgery Center - Pasadena, LLC

Certification status

Active

Provider type (POS)

Ambulatory surgical center

Participating since

Jan 23, 2026

Last certification

Jan 7, 2026

Facility address

590 S Fair Oaks Ave
Pasadena, CA 91105

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

CLIA laboratory certificates

Locations

Interoperability endpoints

• FHIR API: https://fhir-myrecord.cerner.com/r4/e6f9b4bf-142e-47be-8246-33cebe5229b6/

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

{
    "created_epoch": "1728604800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1747353600000",
    "number": "1922828284",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "590 S FAIR OAKS AVE",
            "city": "PASADENA",
            "state": "CA",
            "postal_code": "911052614",
            "telephone_number": "323-442-8747"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "590 S FAIR OAKS AVE",
            "city": "PASADENA",
            "state": "CA",
            "postal_code": "911052614",
            "telephone_number": "323-442-8747"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KECK MEDICINE OF USC SURGERY CENTER, PASADENA - LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "KECK MEDICINE OF USC SURGERY CENTERS, LLC",
        "enumeration_date": "2024-10-11",
        "last_updated": "2025-05-16",
        "certification_date": "2025-05-16",
        "status": "A",
        "authorized_official_last_name": "CHURCH",
        "authorized_official_first_name": "JEREMY",
        "authorized_official_title_or_position": "CFO/USC CARE MEDICAL GROUP, INC.",
        "authorized_official_telephone_number": "323-442-8747"
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Shant Kazazian, M.D.
• Shadi Kazourra, MD
• Ellyn Peace Kearney, AMFT
• John Keay
• Keck Medicine of Usc Imaging Centers, LLC
• Steven Traylor Keightley, LMFT
• Charles Aage Keldsen
• Amy Elizabeth Keller, LMFT, PSYD
• Cassmier Keller
• Natalie Rose Keller, MD STUDENT

• Ambulatory Surgical Clinic/Center in Pasadena, CA
• Providers in Pasadena, 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 May 16, 2025; 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.