Brentwood Surgery Center, LLC

Primary specialty

Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X

Legal business name

BRENTWOOD SURGERY CENTER, LLC

Practice address

2400 Balfour Rd
Suite 320
Brentwood, CA 94513-4945

Phone

(925) 240-2059

Fax

(925) 240-2156

NPI assigned

Jul 15, 2006

Organization subpart

No

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

Authorized official

Name

Mrs. Alexandra Rosamond Luckhardt, RN

Title

Administrator

Phone

(925) 240-2059

Specialties & licenses 1

Addresses

Other names 1

• Brentwood Surgery Center Doing business as

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Ambulatory surgical center certification: CCN 05C0001778

Legal name

BRENTWOOD SURGERY CENTER

Certification status

Active

Provider type (POS)

Ambulatory surgical center

Participating since

Nov 7, 2006

Last certification

Mar 6, 2018

Ownership / control type

Proprietary

Facility address

2400 Balfour Road, Third Floor, Suite 320
Brentwood, CA 94513

Member of 2

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

• Golden State Orthopedics & Spine

  • Orthopaedic Surgery Physician
  • Brentwood, CA
  • NPI 1972309920

  Member Of

  NPD member
• John Muir Health

  • Rehabilitation Hospital Unit
  • Walnut Creek, CA
  • NPI 1447269303

  Member Of

  NPD member

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Premjit S Chahal, M.D.

  • Specialist
  • Concord, CA
  • NPI 1093893091
  NPD (past)
• Jenny F Jew, M.D.

  • Gastroenterology Physician
  • Concord, CA
  • NPI 1356504476
  NPD (past)

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

{
    "created_epoch": "1152921600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1692662400000",
    "number": "1982620522",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2400 BALFOUR RD",
            "address_2": "SUITE 320",
            "city": "BRENTWOOD",
            "state": "CA",
            "postal_code": "945134945",
            "telephone_number": "925-240-2059",
            "fax_number": "925-240-2156"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2400 BALFOUR RD",
            "address_2": "SUITE 320",
            "city": "BRENTWOOD",
            "state": "CA",
            "postal_code": "945134945",
            "telephone_number": "925-240-2059",
            "fax_number": "925-240-2156"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BRENTWOOD SURGERY CENTER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-15",
        "last_updated": "2023-08-22",
        "certification_date": "2023-08-22",
        "status": "A",
        "authorized_official_last_name": "LUCKHARDT",
        "authorized_official_first_name": "ALEXANDRA",
        "authorized_official_middle_name": "ROSAMOND",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "925-240-2059",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "RN"
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": "CA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Brentwood Surgery Center",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Brentwood Surgery Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Ambulatory Surgical Clinic/Center in Brentwood, CA
• Providers in Brentwood, 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, 2023; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.