SUTTER AMADOR SURGERY CENTER LLC NPI 1033453311

NPI Information

  • NPI: 1033453311
  • Provider Name: SUTTER AMADOR SURGERY CENTER LLC
  • Classification: Clinic/Center - 261QA1903X
  • Specialization: Ambulatory Surgical
  • Entity Type: Organization
  • Doing Business As: SUTTER AMADOR SURGERY CENTER
  • CLIA Number: 05D1036653
  • Address: 223 CLINTON RD
    STE 204
    JACKSON, CA
    ZIP 95642
  • Phone: (209) 223-5938

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NPI Details

SUTTER AMADOR SURGERY CENTER LLC is an ambulatory surgical clinic center in Jackson, CA. SUTTER AMADOR SURGERY CENTER LLC NPI is 1033453311. The provider is registered as an organization entity type.
The provider Is Doing Business As Sutter Amador Surgery Center.

The provider's business location address is:

223 CLINTON RD
STE 204
JACKSON, CA
ZIP 95642-680
Phone: (209) 223-5938
Fax: (209) 257-1599

The provider's authorized official is William D. Davis .
The authorized official title is Board Chairman and has the following contact phone number (916) 286-8202.

The CLIA number assigned to this NPI record is 05D1036653 - ambulatory surgery center with a certificate type of Certificate of Waiver.

The following top HCPCS codes were publicly reported for this provider under the Medicare program for the year 2016. The reported codes are based on the top codes for each available Medicare specialty, excluding evaluation and management codes.

  • Phenylephrine 10.16 mg/ml and ketorolac 2.88 mg/ml ophthalmic irrigation solution, 1 ml (HCPCS:J1097)
  • Injection of substance into lower spine canal using imaging guidance (HCPCS:62323)
  • Removal of cataract with insertion of prosthetic lens (HCPCS:66984)
  • Injection of substance into middle or upper spine canal using imaging guidance (HCPCS:62321)
  • Removal of recurring cataract in lens capsule using a laser (HCPCS:66821)
  • Injection of lower or sacral spine facet joint using imaging guidance, single level (HCPCS:64493)
  • Removal of polyps or growths of large bowel using an endoscope with mechanical snare (HCPCS:45385)
  • Injection procedure for sacroiliac joint; provision of anesthetic, steroid and/or other therapeutic agent, with or without arthrography (HCPCS:G0260)
  • Colorectal cancer screening; colonoscopy on individual not meeting criteria for high risk (HCPCS:G0121)
  • Destruction of polyp or growth of large bowel using a flexible endoscope (HCPCS:45388)

The enumeration date for this NPI number is 11/26/2012 and was last updated on 11/26/2012.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1261QA1903XClinic/CenterAmbulatory SurgicalYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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