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PACIFIC SURGERY CENTER OF VTA
NPI 1073693123
Clinic/Center - Ambulatory Surgical in Ventura, CA

Active since October 16, 2006CLIA 05D1018686 · Waiver
3805 TELEGRAPH RD, VENTURA, CA 93003(805) 644-9001(805) 654-1103 Get Directions Write a Review

NPPES record last updated: April 28, 2008. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Pacific Surgery Center Of Vta NPPES

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

PACIFIC SURGERY CENTER OF VTA (NPI 1073693123) is a healthcare organization registered as an ambulatory surgical in Ventura, California and active in the NPI registry since October 2006. The organization holds a CLIA Waiver certificate valid through October 28, 2027 and lists Keith Wintermute, Administrator, as its authorized official.

NPPES Registry Identity

NPI1073693123
Entity TypeOrganization
Primary Taxonomy261QA1903X
Legal Business NamePCSC 15 INC
Location Address3805 TELEGRAPH RDVentura, CA 93003-3422
Mailing Address3805 Telegraph RdVentura, CA 93003-3422 · (805) 644-9001 · Fax (805) 654-1103
Phone(805) 644-9001
Fax(805) 654-1103
Organization SubpartNo
Authorized OfficialKeith WintermuteAdministrator · (805) 644-9001
Enumeration DateOctober 16, 2006
Last NPPES UpdateApril 28, 2008
✔ NPI 1073693123 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyClinic/Center · Ambulatory SurgicalAmbulatory Health Care Facilities
Taxonomy Code261QA1903X
License✔ Licensed in CA · 050000581
3805 TELEGRAPH RD, Ventura, CA 93003
Open in Google Maps ↗

Other Names 1

Doing Business AsPacific Surgery Center Of Vta

Other Identifiers 4

OtherZZZH5616ZCA · Blue Shield Prov. #
Other005279CA · Blue Cross Prov. #
Other99204CA · Health Partners Prov. #
Medicare PINS051668CA

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 05D1018686

Pacific Surgery Center Of Ventura · Ventura, CA
Active · expires Oct 28, 2027
CLIA Number05D1018686
Laboratory TypeAmbulatory Surgery Center
Certificate Effective DateOctober 29, 2025
Certificate Expiration DateOctober 28, 2027
Laboratory DirectorBryant J. Lum
Laboratory Phone(805) 644-9001
Laboratory LocationPacific Surgery Center Of Ventura3805 Telegraph Rd, Ventura, CA 93003
CLIA data matches this NPI record on: Address Phone
This certificate is issued to a laboratory to perform only waived tests.

Areas of Expertise CMS Part B claims 11

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.

Removal of recurring cataract in lens capsule using a laser 66821
This procedure, known as YAG laser capsulotomy, treats cloudiness in the lens capsule following cataract surgery. A laser is used to create a small hole in the cloudy capsule, allowing light to pass through and restore clear vision. It's a quick, painless procedure.
226 services160 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.
222 services129 patients
Correction of toe joint deformity 28285
Correction of toe joint deformity is a procedure to fix misshapen toe joints. This can involve realigning the bones, removing bone or tissue, or implanting devices to improve joint function. It can help reduce pain and improve mobility.
34 services19 patients
Complex removal of cataract with insertion of prosthetic lens 66982
This procedure involves removing a cloudy lens (cataract) from your eye and replacing it with a clear, artificial lens. It helps restore vision that has been affected by the cataract. The operation is usually done under local anesthesia.
31 services22 patients
Revision or repair of operative wound of eye 66250
A revision or repair of an operative wound of the eye is a procedure to fix complications from a previous eye surgery. It involves addressing issues like infection, healing problems, or incorrect positioning of surgical materials. The goal is to promote proper healing and restore optimal eye function.
28 services20 patients
Extracapsular removal of cataract with insertion of artificial lens and insertion of drainage device in front chamber of eye 66991
This is a two-part eye procedure. First, a cloudy lens (cataract) is removed from its outer layer and replaced with an artificial lens to improve vision. Second, a drainage device is inserted into the front part of the eye to manage fluid levels, preventing pressure build-up.
26 services17 patients

Other Providers at the Same Location NPPES 3

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

MESA SURGERY CENTER LLC
Clinic/Center (Ambulatory Surgical)
3805 TELEGRAPH RD
VENTURA, CA 93003
Ventura County (818) 855-1507
MWP UROLOGY, INC
Urology
3805 TELEGRAPH RD
VENTURA, CA 93003
Ventura County (805) 644-9001
XUAN HA PHAM CRNA, A PROFESSIONAL NURSING CORPORATION, INC.
Nurse Anesthetist, Certified Registered
3805 TELEGRAPH RD
VENTURA, CA 93003
Ventura County (818) 918-0500

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 Pcsc 15 Inc's NPI number?

The NPI number for Pcsc 15 Inc is 1073693123. It was assigned to this organization in the NPPES registry on October 16, 2006. The provider is doing business as Pacific Surgery Center Of Vta.

Where is Pcsc 15 Inc located?

Pcsc 15 Inc is located at 3805 Telegraph Rd, Ventura, CA 93003. The listed phone number is (805) 644-9001.

What is Pcsc 15 Inc's specialty?

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

Does Pcsc 15 Inc hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 05D1018686) is associated with this NPI, valid through October 28, 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 Pcsc 15 Inc was last updated on April 28, 2008. NPI Profile syncs with the weekly NPPES data releases published by CMS.