San Leandro Surgery Center LTD

Primary specialty

Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X

License

140000348 Issued in CA

Legal business name

SAN LEANDRO SURGERY CENTER LTD

Practice address

15035 E 14TH Street
San Leandro, CA 94578-1901

Phone

(510) 276-2800

Fax

(510) 276-6896

NPI assigned

Aug 2, 2005

Organization subpart

No

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

Authorized official

Name

Bradley Heaton

Title

Ceo

Phone

(916) 566-4907

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Listed as

San Leandro Surgery Center LTD a California Limited PartnershipCCN 05C0001175

Medicare certification status

ActiveFrom the Provider of Services file

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

• Sutter Bay Hospitals

  • Community/Retail Pharmacy
  • Oakland, CA
  • NPI 1699281501

  Member Of

  NPD member

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

{
    "created_epoch": "1122940800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1715126400000",
    "number": "1952302895",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15035 E 14TH STREET",
            "city": "SAN LEANDRO",
            "state": "CA",
            "postal_code": "945781901",
            "telephone_number": "510-276-2800",
            "fax_number": "510-276-6896"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15035 E 14TH STREET",
            "city": "SAN LEANDRO",
            "state": "CA",
            "postal_code": "945781901",
            "telephone_number": "510-276-2800",
            "fax_number": "510-276-6896"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SAN LEANDRO SURGERY CENTER LTD",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-08-02",
        "last_updated": "2024-05-08",
        "certification_date": "2024-05-08",
        "status": "A",
        "authorized_official_last_name": "HEATON",
        "authorized_official_first_name": "BRADLEY",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "916-566-4907"
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": "CA",
            "license": "140000348",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Annette Samuel, PHN
• San Leandro Health Care Center, Inc.
• San Leandro Optometry GRP
• San Leandro Sleep Disorders Center, Prof. Corp.
• San Leandro Surgery Center
• San Leandro Unified School District
• Esther San Nicolas, DDS
• April Ann Sanchez Lerma, LCSW
• Diana Sanchez Olivas
• Alejandria Sanchez- Warren Sanchez- Warren

• Ambulatory Surgical Clinic/Center in San Leandro, CA
• Providers in San Leandro, 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 8, 2024; 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.