EVERGREEN SURGERY CENTER LLC NPI 1538618368

NPI Information

  • NPI: 1538618368
  • Provider Name: EVERGREEN SURGERY CENTER, LLC
  • Classification: Clinic/Center - 261QA1903X
  • Specialization: Ambulatory Surgical
  • Entity Type: Organization
  • CLIA Number: 05D2124212
  • Address: 2365 QUIMBY RD STE 180
    SAN JOSE, CA
    ZIP 95122
  • Phone: (408) 620-5675

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NPI Details

EVERGREEN SURGERY CENTER, LLC is an ambulatory surgical clinic center in San Jose, CA. EVERGREEN SURGERY CENTER, LLC NPI is 1538618368. The provider is registered as an organization entity type.

The provider's business location address is:

2365 QUIMBY RD STE 180
SAN JOSE, CA
ZIP 95122-337
Phone: (408) 620-5675
Fax: (408) 223-1534

The provider's authorized official is Hector Cervantes .
The authorized official title is Partner and has the following contact phone number (408) 620-5723.

The CLIA number assigned to this NPI record is 05D2124212 - 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.

  • Insertion of heart rhythm monitor under skin (HCPCS:33285)
  • Removal of heart rhythm monitor from under the skin (HCPCS:33286)
  • Insertion of pacemaker and upper and lower heart chamber electrode (HCPCS:33208)

The enumeration date for this NPI number is 9/21/2016 and was last updated on 2/4/2019.

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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