SANTA ROSA AMBULATORY SURGICAL CENTER MEDICAL GROUP INC
NPI 1215002852
Clinic/Center - Ambulatory Surgical in Santa Rosa, CA

NPI Status: Active since November 21, 2006

Contact Information

76 BROOKWOOD AVE STE B
SANTA ROSA, CA
ZIP 95404
Phone: (707) 523-4907
Fax: (707) 523-4953

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  • Organization
  • Clinic/Center
  • Ambulatory Surgical
  • CLIA Number: 05D1029802
  • CLIA Cert. Type: Other
  • CLIA Exp. Date: 08-23-2026

About SANTA ROSA AMBULATORY SURGICAL CENTER MEDICAL GROUP INC

This page provides the complete NPI Profile along with additional information for Santa Rosa Ambulatory Surgical Center Medical Group Inc, a provider established in Santa Rosa, California operating as a Clinic/center, focusing in ambulatory surgical . The healthcare provider is registered in the NPI registry with number 1215002852 assigned on November 2006. The practitioner's primary taxonomy code is 261QA1903X. The provider is registered as an organization and their NPI record was last updated 13 years ago. The authorized official of this NPI record is Sophie Pappas (Cfo)

NPI
1215002852
Provider Name
SANTA ROSA AMBULATORY SURGICAL CENTER MEDICAL GROUP INC
Entity Type
Organization
Location Address
76 BROOKWOOD AVE STE B SANTA ROSA, CA 95404
Location Phone
(707) 523-4907
Location Fax
(707) 523-4953
Mailing Address
76 BROOKWOOD AVE STE B SANTA ROSA, CA 95404
Mailing Phone
(707) 523-4907
Mailing Fax
(707) 523-4953
Is Sole Proprietor?
No
Is Organization Subpart?
No
Enumeration Date
11-21-2006
Last Update Date
07-17-2013
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Specialty - Primary Taxonomy

The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Classification

Clinic/Center Ambulatory Surgical

Taxonomy Code
261QA1903X
Type
Ambulatory Health Care Facilities

Insurance Plans Accepted

According to publicly available information the provider might be accepting the following health plans from these health insurance companies:

Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.

Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.

*Please verify directly with this provider to make sure your insurance plan is currently accepted.

Authorized Official

The authorized official is the designated individual with the legal authority to make changes to the provider’s official NPI record. For organizations, the authorized official must be a general partner, chairman of the board, CEO, CFO or a direct owner holding at least a 5 percent stake in the medical organization.

Authorized Official Name

SOPHIE PAPPAS

Authorized Official Title
CFO
Authorized Official Phone
(707) 523-4907

Additional Identifiers

The NPI Enumerator encourages providers to submit additional identifiers with their NPI application although the submission of this information is optional. The additional identifier(s) section includes other numbers or codes currently or formerly used as an identifier for the provider by other public healthcare entities. The identifiers may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.

Identifier Type / Code Identifier State Identifier Issuer
ZZZ25482ZMEDICARE ID-TYPE UNSPECIFIED (04)CA 

Areas of Expertise

The following services and procedures, recently provided to Medicare patients, illustrate the range of care this provider offers. This list reflects the variety of services available to all patients visiting the practice and is based on 2022 Medicare dataset. In general, the more frequently a provider treats specific conditions or performs particular procedures, the more experienced they become in addressing similar patient needs. The provider has delivered many of the services listed below to Medicare patients. Please note that this list does not include services provided to patients who are not covered by Medicare.

Fusion of pelvic joint using imaging guidance

This procedure involves joining or "fusing" the pelvic joint to alleviate pain or stabilize the area. It's performed under imaging guidance, which helps the doctor visualize the area and ensure precise placement of medical tools. This can improve recovery and outcome.

This service was performed 20 times for 17 patients

Fusion of spine in lower back

Fusion of the spine in the lower back, also known as lumbar spinal fusion, is a surgery aimed to join, or fuse, two or more vertebrae in your lower back. This procedure can help alleviate pain and improve stability by reducing movement between the vertebrae.

This service was performed 33 times for 33 patients

Fusion of upper spine bones through front of neck with partial removal of disc

This procedure involves fusing the upper spine bones via the front of the neck. A part of the disc is removed to ease pressure on the spinal cord and nerves. This can help reduce pain and improve mobility.

This service was performed 20 times for 19 patients

Partial removal of spine bone with release of lower spinal cord and/or nerves, 1 segment

This procedure involves removing part of a spine bone to alleviate pressure on the lower spinal cord and/or nerves. It targets a single segment of the spine, improving mobility and reducing pain. It's a common treatment for conditions like herniated discs or spinal stenosis.

This service was performed 34 times for 33 patients

Partial removal of spine bone with release of upper spinal cord or nerves and/or removal of disc, 1 interspace

This procedure involves the partial removal of a spine bone to alleviate pressure on the spinal cord or nerves. It may also include the removal of a disc from one interspace. This can help reduce pain and improve mobility.

This service was performed 20 times for 19 patients

CLIA Information

The Clinical Laboratory Improvement Amendments (CLIA) of 1988 applies to facilities or sites that test human specimens for health assessment or to diagnose, prevent, or treat disease. The CLIA Program sets standards for clinical laboratory testing and issues certificates. The NPI / CLIA crosswalk information for this NPI number is:

CLIA Number
05D1029802
Facility Type
Other
Certificate Effective Date
August 24, 2024
Certificate Expiration Date
August 23, 2026
Laboratory Director
MERTON GOODE, MD
Certificate Type
Certificate of Waiver
Certificate Type Description
This CLIA certificate is issued to Santa Rosa Ambulatory Surgical Center Medical Group Inc to perform only waived tests. CLIA defines waived tests as simple tests with a low risk for an incorrect result. Waived tests include certain tests listed in CLIA regulations, tests cleared by the FDA for home use and tests approved by the FDA for waived status and that meet CLIA waiver criteria.

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NPI NPI Number Validation

How NPI Validation Works

The NPI validation process uses the ISO-standard Luhn algorithm, a mathematical "handshake", to ensure that a provider's 10-digit ID is authentic and free of common typing errors.

To verify the NPI 1215002852, we treat the final digit (2) as the Check Digit—the target answer we need to reach. The process begins by taking the first nine digits and adding a constant value of 24, which accounts for the "80840" prefix required for all U.S. health identifiers. We then double every other digit starting from the right and sum the individual digits of those results together. For this specific NPI, that total comes to 48. The final step is to find the difference between that total and the next multiple of ten (50 - 48 = 2).

Digit-by-digit view

Use the first nine digits for the calculation. Starting from the right, double every other digit. The last digit is the check digit and is not part of the calculation.

Pos 1
1
Doubled → 2
Pos 2
2
Unchanged
Pos 3
1
Doubled → 2
Pos 4
5
Unchanged
Pos 5
0
Doubled → 0
Pos 6
0
Unchanged
Pos 7
2
Doubled → 4
Pos 8
8
Unchanged
Pos 9
5
Doubled → 10 → 1 + 0
Check
2
Target digit
Regular digit Doubled digit Check digit

Step 1: Double every other digit from the right

Starting with the rightmost digit of the first nine digits, double every other value. If doubling creates a two-digit number, add those digits together.

1 → 2 1 → 2 0 → 0 2 → 4 5 → 10 → 1

Step 2: Add all digits plus the NPI constant

Add the transformed values, the unchanged digits, and the constant 24.

2 + 2 + 2 + 5 + 0 + 0 + 4 + 8 + 1 + 0 + 24 = 48

Step 3: Find the amount needed to reach the next multiple of 10

The next multiple of ten after 48 is 50. The difference is the calculated check digit.

50 - 48 = 2
This NPI is valid
The calculated check digit is 2, which matches the last digit of 1215002852.

Other Providers at the Same Location


The following 2 providers are registered at the same or a nearby location.

Anesthesiology
76 BROOKWOOD AVE STE B
SANTA ROSA, CA 95404
Anesthesiology
76 BROOKWOOD AVE STE B
SANTA ROSA, CA 95404

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1215002852, enumerated as an "organization" on November 21, 2006.

The provider is located at 76 BROOKWOOD AVE STE B SANTA ROSA, CA 95404 and the phone number is (707) 523-4907.

Clinic/Center with taxonomy code 261QA1903X and a focus in Ambulatory Surgical.

The provider might be accepting Accepts: Medicare and Medicaid. Please consult your insurance carrier or call the provider to verify.