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EVERGREEN SURGERY CENTER, LLC
NPI 1538618368
Clinic/Center - Ambulatory Surgical in San Jose, CA

Active since September 21, 2016CLIA 05D2124212 · Waiver
2365 QUIMBY RD STE 180, SAN JOSE, CA 95122(408) 620-5675(408) 223-1534 Get Directions Write a Review

NPPES record last updated: February 4, 2019. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Feb 4, 2019, Jan 22, 2019, Sep 21, 2016 (3 updates tracked since 2016).

About Evergreen Surgery Center, Llc NPPES

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

EVERGREEN SURGERY CENTER, LLC (NPI 1538618368) is a healthcare organization registered as an ambulatory surgical in San Jose, California and active in the NPI registry since September 2016. The organization holds a CLIA Waiver certificate valid through January 10, 2027 and lists Hector Cervantes, Partner, as its authorized official.

NPPES Registry Identity

NPI1538618368
Entity TypeOrganization
Primary Taxonomy261QA1903X
Legal Business NameEVERGREEN SURGERY CENTER, LLC
Location Address2365 QUIMBY RD STE 180San Jose, CA 95122-1337
Mailing Address2365 Quimby Rd Ste 180San Jose, CA 95122-1337 · (408) 620-5675 · Fax (408) 223-1534
Phone(408) 620-5675
Fax(408) 223-1534
Organization SubpartNo
Authorized OfficialHector CervantesPartner · (408) 620-5723
Enumeration DateSeptember 21, 2016
Last NPPES UpdateFebruary 4, 20193 updates tracked since enumeration
✔ NPI 1538618368 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyClinic/Center · Ambulatory SurgicalAmbulatory Health Care Facilities
Taxonomy Code261QA1903X
2365 QUIMBY RD STE 180, San Jose, CA 95122
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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 05D2124212

Evergreen Surgery Center · San Jose, CA
Active · expires Jan 10, 2027
CLIA Number05D2124212
Laboratory TypeAmbulatory Surgery Center
Certificate Effective DateJanuary 11, 2025
Certificate Expiration DateJanuary 10, 2027
Laboratory DirectorSteven Johnson, MD
Laboratory Phone(408) 620-5675
Laboratory LocationEvergreen Surgery Center2365 Quimby Rd Ste 180, San Jose, CA 95122
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

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.

Insertion of pacemaker and upper and lower heart chamber electrode 33208
A pacemaker insertion is a procedure where a small device, called a pacemaker, is implanted under your skin. This device uses electrical pulses to prompt the heart to beat at a normal rate. Electrodes are placed in the upper and lower chambers of your heart to help regulate your heartbeat.
13 services13 patients

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 Evergreen Surgery Center, LLC's NPI number?

The NPI number for Evergreen Surgery Center, LLC is 1538618368. It was assigned to this organization in the NPPES registry on September 21, 2016.

Where is Evergreen Surgery Center, LLC located?

Evergreen Surgery Center, LLC is located at 2365 Quimby Rd Ste 180, San Jose, CA 95122. The listed phone number is (408) 620-5675.

What is Evergreen Surgery Center, LLC's specialty?

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

Does Evergreen Surgery Center, LLC hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 05D2124212) is associated with this NPI, valid through January 10, 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 Evergreen Surgery Center, LLC was last updated on February 4, 2019. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 7 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.