SEBASTOPOL ASC L.P. NPI 1154440972

NPI Information

  • NPI: 1154440972
  • Provider Name: SEBASTOPOL ASC, L.P.
  • Classification: Clinic/Center - 261QA1903X
  • Specialization: Ambulatory Surgical
  • Entity Type: Organization
  • CLIA Number: 05D0895558
  • Address: 6880 PALM AVE
    SEBASTOPOL, CA
    ZIP 95472
  • Phone: (707) 823-7628

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NPI Details

SEBASTOPOL ASC, L.P. is an ambulatory surgical clinic center in Sebastopol, CA. SEBASTOPOL ASC, L.P. NPI is 1154440972. The provider is registered as an organization entity type.

The provider's business location address is:

6880 PALM AVE
SEBASTOPOL, CA
ZIP 95472-270
Phone: (707) 823-7628
Fax: (707) 823-1521

The provider's authorized official is Eric J Kahle .
The authorized official title is Corporate Officer and has the following contact phone number (707) 823-7628.

The CLIA number assigned to this NPI record is 05D0895558 - 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)
  • Removal of cataract with insertion of prosthetic lens (HCPCS:66984)
  • Removal of recurring cataract in lens capsule using a laser (HCPCS:66821)
  • Removal of excessive skin of upper eyelid (HCPCS:15822)
  • Laser repair to improve eye fluid flow (HCPCS:65855)

The enumeration date for this NPI number is 3/29/2007 and was last updated on 1/27/2012.

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 Surgical010000189CALIFORNIAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
11154440972OTHERMEDICARE NPI
2ZZZH4909ZOTHERCALIFORNIABLUE SHIELD
3490002015OTHERCALIFORNIAMEDICARE RET RAILROAD
4ZZZ43102ZMEDICARE PIN
5551098OTHERCALIFORNIABLUE CROSS
6SUR51098FMEDICAIDCALIFORNIA

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: 3/30/2025

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