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

Q: What is Santa Rosa Ambulatory Surgical Center Medical Group Inc's specialty?

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

Active since November 21, 2006CLIA 05D1029802 · Waiver

76 BROOKWOOD AVE STE B, SANTA ROSA, CA 95404(707) 523-4907(707) 523-4953 Get Directions Write a Review

NPPES record last updated: July 17, 2013. Verified against the NPPES registry weekly; last sync: July 26, 2026.

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About Santa Rosa Ambulatory Surgical Center Medical Group Inc NPPES

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

SANTA ROSA AMBULATORY SURGICAL CENTER MEDICAL GROUP INC (NPI 1215002852) is a healthcare organization registered as an ambulatory surgical in Santa Rosa, California and active in the NPI registry since November 2006. The organization holds a CLIA Waiver certificate valid through August 23, 2026 and lists Sophie Pappas, Cfo, as its authorized official.

NPPES Registry Identity

NPI1215002852

Entity TypeOrganization

Primary Taxonomy261QA1903X

Legal Business NameSANTA ROSA AMBULATORY SURGICAL CENTER MEDICAL GROUP INC

Location Address76 BROOKWOOD AVE STE BSanta Rosa, CA 95404-4312

Mailing Address76 Brookwood Ave Ste BSanta Rosa, CA 95404-4312 · (707) 523-4907 · Fax (707) 523-4953

Phone(707) 523-4907

Fax(707) 523-4953

Organization SubpartNo

Authorized OfficialSophie PappasCfo · (707) 523-4907

Enumeration DateNovember 21, 2006

Last NPPES UpdateJuly 17, 2013

✔ NPI 1215002852 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyClinic/Center · Ambulatory SurgicalAmbulatory Health Care Facilities

Taxonomy Code261QA1903X

76 BROOKWOOD AVE STE B, Santa Rosa, CA 95404

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Other Identifiers 1

Medicare ID-Type UnspecifiedZZZ25482ZCA

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 05D1029802

Santa Rosa Ambulatory Surgical Center · Santa Rosa, CA

Active · expires Aug 23, 2026

CLIA Number05D1029802

Laboratory TypeOther

Certificate Effective DateAugust 24, 2024

Certificate Expiration DateAugust 23, 2026

Laboratory DirectorMerton Goode, MD

Laboratory Phone(707) 523-4907

Laboratory LocationSanta Rosa Ambulatory Surgical Center76 Brookwood Ave Suite B, Santa Rosa, CA 95404

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 4

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.

Partial removal of spine bone with release of lower spinal cord and/or nerves, 1 segment 63047

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.

57 services45 patients

Fusion of spine in lower back 22612

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.

55 services45 patients

Partial removal of spine bone with release of upper spinal cord and/or nerves, 1 segment 63045

This procedure involves removing a part of your spine bone to alleviate pressure on the upper spinal cord or nerves. It's performed on one segment of the spine to improve nerve function and reduce pain.

22 services17 patients

Fusion of pelvic joint using imaging guidance 27279

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.

17 services15 patients

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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.

BROOKWOOD ANESTHESIA INC

Anesthesiology

76 BROOKWOOD AVE STE B
SANTA ROSA, CA 95404

Sonoma County (707) 523-4907

CA 22 LLC

Anesthesiology

76 BROOKWOOD AVE STE B
SANTA ROSA, CA 95404

Sonoma County (707) 523-4907

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 Santa Rosa Ambulatory Surgical Center Medical Group Inc's NPI number?

The NPI number for Santa Rosa Ambulatory Surgical Center Medical Group Inc is 1215002852. It was assigned to this organization in the NPPES registry on November 21, 2006.

Where is Santa Rosa Ambulatory Surgical Center Medical Group Inc located?

Santa Rosa Ambulatory Surgical Center Medical Group Inc is located at 76 Brookwood Ave Ste B, Santa Rosa, CA 95404. The listed phone number is (707) 523-4907.

What is Santa Rosa Ambulatory Surgical Center Medical Group Inc's specialty?

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

Does Santa Rosa Ambulatory Surgical Center Medical Group Inc hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 05D1029802) is associated with this NPI, valid through August 23, 2026. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Santa Rosa Ambulatory Surgical Center Medical Group Inc was last updated on July 17, 2013. 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.