Scripps Mercy Ambulatory Surgery Center, LP

Primary specialty

Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X

Legal business name

SCRIPPS MERCY AMBULATORY SURGERY CENTER, LP

Practice address

550 Washington St
Suite 101
San Diego, CA 92103-2213

Phone

(619) 686-3434

Fax

(619) 686-3618

NPI assigned

Dec 26, 2006

Organization subpart

No

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

Authorized official

Name

Mr. Steven Michael Green

Title

Executive Director

Phone

(619) 686-3434

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Scripps Mercy Surgery Pavilion Doing business as

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Listed as

Scripps Mercy Surgery PavilionCCN 05C0001670

Medicare certification status

ActiveFrom the Provider of Services file

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

CLIA laboratory certificates

Member of 1

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

• Scripps Clinic Medical Laboratories

  • Clinical Medical Laboratory
  • San Diego, CA
  • NPI 1578549044

  Member Of

  NPD member

Networks

• BSC 65 PLUS INDIVIDUAL MAPDPlans: Blue Shield 65 Plus (HMO) (H0504-015-000, H0504); Blue Shield 65 Plus (HMO) (H0504-039-000, H0504); Blue Shield 65 Plus Plan 2 (HMO) (H0504-021-000, H0504); Blue Shield Inspire (HMO) (H0504-041-000, H0504); Blue Shield 65 Plus (HMO) (H0504-038-000, H0504); Blue Shield Inspire (HMO) (H0504-047-000, H0504); Blue Shield 65 Plus (HMO) (H0504-026-000, H0504); Blue Shield Advantage (HMO) (H0504-050-000, H0504); Blue Shield AdvantageOptimum Plan (HMO) (H5928-004-000, H5928); Blue Shield Inspire (HMO) (H0504-043-000, H0504)…

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

{
    "created_epoch": "1167091200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1972668317",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "550 WASHINGTON ST",
            "address_2": "SUITE 101",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921032213",
            "telephone_number": "619-686-3434",
            "fax_number": "619-686-3618"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "550 WASHINGTON ST",
            "address_2": "SUITE 101",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921032213",
            "telephone_number": "619-686-3434",
            "fax_number": "619-686-3618"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SCRIPPS MERCY AMBULATORY SURGERY CENTER, LP",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-26",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "GREEN",
        "authorized_official_first_name": "STEVEN",
        "authorized_official_middle_name": "MICHAEL",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "619-686-3434",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": "CA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "SUR01670F",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Scripps Mercy Surgery Pavilion",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Scripps Health
• Scripps Health Dba Scripps Medical Foundation
• Scripps Health Inpatient Providers Medical Group Inc.
• Scripps Health Inpatient Providers Medical Group Inc.
• Scripps Health Services, LLC
• Scripps Mercy Physicians Cardiology Medical Corporation
• Scripps Optometric Group
• Scripps Oral Pathology Service, LLC
• Scripps Psychiatric Medical Group
• Scripps Ranch Dental

• Ambulatory Surgical Clinic/Center in San Diego, CA
• Providers in San Diego, 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 Aug 22, 2020; 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.