PROVIDENCE SPECIALTY SURGERY CENTER LLC
NPI 1861180671
Clinic/Center - Ambulatory Surgical in Orange, CA
About Providence Specialty Surgery Center Llc NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
PROVIDENCE SPECIALTY SURGERY CENTER LLC (NPI 1861180671) is a healthcare organization registered as an ambulatory surgical in Orange, California and active in the NPI registry since April 2023. The organization holds a CLIA Waiver certificate valid through September 18, 2027 and lists Jamshid Shadjareh, Chairman, Governing Body, as its authorized official.
NPPES Registry Identity
Specialties & Licenses
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 05D2290018
Providence Specialty Surgery Center · Orange, CAOther Providers at the Same Location NPPES 2
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
ORANGE, CA 92868
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 Providence Specialty Surgery Center LLC's NPI number?
The NPI number for Providence Specialty Surgery Center LLC is 1861180671. It was assigned to this organization in the NPPES registry on April 28, 2023.
Where is Providence Specialty Surgery Center LLC located?
Providence Specialty Surgery Center LLC is located at 1310 W Stewart Dr Ste 310, Orange, CA 92868. The listed phone number is (714) 204-0444.
What is Providence Specialty Surgery Center LLC's specialty?
The primary specialty registered for this NPI is Clinic/Center, specializing in Ambulatory Surgical, with taxonomy code 261QA1903X.
Does Providence Specialty Surgery Center LLC hold a CLIA laboratory certificate?
Yes. A Certificate of Waiver (number 05D2290018) is associated with this NPI, valid through September 18, 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 Providence Specialty Surgery Center LLC was last updated on April 28, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 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.
# Providence Specialty Surgery Center Llc · NPI 1861180671
Ambulatory Surgical organization in Orange, California. Organization record, active in the CMS NPPES registry since April 28, 2023.
## Identity
- **NPI:** 1861180671 (Entity type: Organization)
- **Enumerated:** April 28, 2023
- **Primary specialty:** Clinic/Center - Ambulatory Surgical · taxonomy 261QA1903X
- **Organization subpart:** No
- **Authorized official:** Jamshid Shadjareh, CHAIRMAN, GOVERNING BODY
## Practice location
- **Address:** 1310 W STEWART DR STE 310, Orange, CA 92868-3838
- **Phone:** (714) 204-0444
## Record status
- **NPPES last updated:** April 28, 2023
- **CLIA laboratory certificates:** 1 on file
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Source: [NPI Profile](https://npiprofile.com/npi/1861180671) · Data from the CMS NPPES public registry.