Organization Active NPI

North Orange County Surgery Center

  • Ambulatory Surgical Clinic/Center
  • Anaheim, CA
National Provider Identifier
1962695122
Registry record updated Sep 25, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X
License
PENDING
Legal business name
NORTH ORANGE COUNTY SURGERY CENTER
Practice address
1741 W Romneya Dr
Suite F
Anaheim, CA 92801-1805
Phone
(714) 408-9481
Fax
(714) 284-0164
NPI assigned
Aug 21, 2007
Last updated
Sep 25, 2014By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 25, 2014

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

Authorized official

Name
Dr. Syam Gaddam, M.D.
Title
Medical Director
Phone
(714) 636-9100

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ambulatory Surgical Clinic/Center 261QA1903X PENDING Primary

Addresses

Primary practice location

1741 W Romneya Dr
Suite F
Anaheim, CA 92801-1805

Mailing address

1741 W Romneya Dr
Suite F
Anaheim, CA 92801-1805
Phone (714) 408-9481

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20080605000917 CA Part B Supplier - Ambulatory Surgical Center 1456421189 Practice locations: Anaheim, CA

Care Compare: Ambulatory surgical center

Medicare Care Compare
Listed as
North Orange County Surgery CenterCCN 05C0001837
Medicare certification status
ActiveFrom the Provider of Services file

Laboratory certificates & supplier records

Derived by NPIMap

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

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
05D1073814North Orange County Surgery Center1741 W Romneya Dr Suite F, Anaheim, CA 92801Certificate of waiverSep 16, 2027

National Provider Directory

National Provider Directory

Locations

1741 W Romneya Dr
Ste F
Anaheim, CA 92801
Phone (714) 408-9481

Practitioners & affiliated clinicians

Practitioners 1

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": "1187654400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1411603200000",
    "number": "1962695122",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1741 W ROMNEYA DR",
            "address_2": "SUITE F",
            "city": "ANAHEIM",
            "state": "CA",
            "postal_code": "928011805",
            "telephone_number": "714-408-9481",
            "fax_number": "714-284-0164"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1741 W ROMNEYA DR",
            "address_2": "SUITE F",
            "city": "ANAHEIM",
            "state": "CA",
            "postal_code": "928011805",
            "telephone_number": "714-408-9481",
            "fax_number": "714-284-0164"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTH ORANGE COUNTY SURGERY CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-08-21",
        "last_updated": "2014-09-25",
        "status": "A",
        "authorized_official_last_name": "GADDAM",
        "authorized_official_first_name": "SYAM",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "17146369100",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": null,
            "license": "PENDING",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Anaheim, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 25, 2014; 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.