1. Home
  2. Directory
  3. California
  4. Jackson
  5. Clinic Center
  6. NPI Profile

SUTTER AMADOR SURGERY CENTER
NPI 1033453311
Clinic/Center - Ambulatory Surgical in Jackson, CA

Active since November 26, 2012CLIA 05D1036653 · Waiver
223 CLINTON RD, STE 204, JACKSON, CA 95642(209) 223-5938(209) 257-1599 Get Directions Write a Review

NPPES record last updated: November 26, 2012. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Sutter Amador Surgery Center NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

SUTTER AMADOR SURGERY CENTER (NPI 1033453311) is a healthcare organization registered as an ambulatory surgical in Jackson, California and active in the NPI registry since November 2012. The organization holds a CLIA Waiver certificate valid through February 6, 2027 and lists William D. Davis, Board Chairman, as its authorized official.

NPPES Registry Identity

NPI1033453311
Entity TypeOrganization
Primary Taxonomy261QA1903X
Legal Business NameSUTTER AMADOR SURGERY CENTER LLC
Location Address223 CLINTON RD, STE 204Jackson, CA 95642-2680
Mailing Address223 Clinton Rd, Ste 204Jackson, CA 95642-2680 · (209) 223-5938 · Fax (209) 257-1599
Phone(209) 223-5938
Fax(209) 257-1599
Organization SubpartNo
Authorized OfficialWilliam D. DavisBoard Chairman · (916) 286-8202
Enumeration DateNovember 26, 2012
✔ NPI 1033453311 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyClinic/Center · Ambulatory SurgicalAmbulatory Health Care Facilities
Taxonomy Code261QA1903X
223 CLINTON RD, Jackson, CA 95642
Open in Google Maps ↗

Other Names 1

Doing Business AsSutter Amador Surgery Center

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 05D1036653

Sutter Amador Surgery Center, LLC · Jackson, CA
Active · expires Feb 6, 2027
CLIA Number05D1036653
Laboratory TypeAmbulatory Surgery Center
Certificate Effective DateFebruary 7, 2025
Certificate Expiration DateFebruary 6, 2027
Laboratory DirectorRobert M. Jarka
Laboratory Phone(209) 223-5938
Laboratory LocationSutter Amador Surgery Center, LLC223 Clinton Rd Ste 204, Jackson, CA 95642
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Areas of Expertise CMS Part B claims 9

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Phenylephrine 10.16 mg/ml and ketorolac 2.88 mg/ml ophthalmic irrigation solution, 1 ml J1097
This solution is used during eye surgery to maintain pupil dilation and reduce inflammation. Phenylephrine widens the pupil, while Ketorolac helps to prevent pain and swelling. It's applied directly to the eye by your healthcare provider during the procedure.
1,600 services236 patients
Removal of cataract with insertion of prosthetic lens 66984
This is a procedure where a cloudy lens in your eye, known as a cataract, is removed. After removal, a clear artificial lens is inserted. This helps to restore your vision, enabling you to see clearly again.
402 services236 patients
Injection of substance into lower spine canal using imaging guidance 62323
This procedure involves injecting a substance into your lower spine canal, guided by real-time images. It's done to diagnose or treat various conditions. You may feel slight discomfort, but it's generally safe and can provide valuable information for your treatment plan.
252 services161 patients
Removal of polyps or growths of large bowel using an endoscope with mechanical snare 45385
This procedure involves using a thin, flexible tube called an endoscope to examine the large bowel. If any abnormal growths or polyps are found, a tool called a mechanical snare is used to remove them. This is a common method to prevent potential health issues.
83 services83 patients
Injection of lower or sacral spine facet joint using imaging guidance, single level 64493
This procedure involves injecting medication into the facet joint in your lower back or sacral spine. It's done under imaging guidance to ensure accuracy. The aim is to alleviate pain and inflammation. It's a safe, often effective method for managing spinal discomfort.
51 services15 patients
Injection of substance into middle or upper spine canal using imaging guidance 62321
This procedure involves injecting a substance into your middle or upper spine canal. It's performed under imaging guidance to ensure accuracy. The substance can help diagnose or treat various conditions, providing relief from symptoms.
48 services32 patients

Other Providers at the Same Location NPPES 2

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

VICKI CHEW MD INC
Anesthesiology
223 CLINTON RD, SUITE 204
JACKSON, CA 95642
Amador County (209) 223-5938
GREGORY S VUKSINICH, M.D., INC
Anesthesiology
223 CLINTON RD, STE 204
JACKSON, CA 95642
Amador County (775) 747-5050

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Sutter Amador Surgery Center LLC's NPI number?

The NPI number for Sutter Amador Surgery Center LLC is 1033453311. It was assigned to this organization in the NPPES registry on November 26, 2012. The provider is doing business as Sutter Amador Surgery Center.

Where is Sutter Amador Surgery Center LLC located?

Sutter Amador Surgery Center LLC is located at 223 Clinton Rd Ste 204, Jackson, CA 95642. The listed phone number is (209) 223-5938.

What is Sutter Amador Surgery Center LLC's specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Ambulatory Surgical, with taxonomy code 261QA1903X.

Does Sutter Amador Surgery Center LLC hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 05D1036653) is associated with this NPI, valid through February 6, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Sutter Amador Surgery Center LLC was last updated on November 26, 2012. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 13 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.