ST. JOSEPH'S SURGERY CENTER LP NPI 1619974219

NPI Information

NPI: 1619974219
Provider Name: ST. JOSEPH'S SURGERY CENTER LP
Classification: Clinic/Center - 261QA1903X
Specialization: Ambulatory Surgical
Entity Type: Organization
CLIA Number: 05D0609154
Address: 1800 N CALIFORNIA ST
STE 1
STOCKTON, CA
ZIP 95204
Phone: (209) 467-6316

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NPI Details

ST. JOSEPH'S SURGERY CENTER LP is an ambulatory surgical clinic center in Stockton, CA. ST. JOSEPH'S SURGERY CENTER LP NPI is 1619974219. The provider is registered as an organization entity type.

The provider's business location address is:

1800 N CALIFORNIA ST
STE 1
STOCKTON, CA
ZIP 95204-019
Phone: (209) 467-6316
Fax: (209) 461-6895

The provider's authorized official is Eric Boon .
The authorized official title is Authorized Official and has the following contact phone number (480) 567-0269.

The CLIA number assigned to this NPI record is 05D0609154 - hospital with a certificate type of Certificate of Accreditation.

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.

Biopsy of esophagus, stomach, and/or upper small bowel using a flexible endoscope (HCPCS:43239)
Removal of polyps or growths of large bowel using an endoscope with mechanical snare (HCPCS:45385)
Biopsy of large bowel using a flexible endoscope (HCPCS:45380)
Diagnostic exam of large bowel using a flexible endoscope (HCPCS:45378)
Colorectal cancer screening; colonoscopy on individual not meeting criteria for high risk (HCPCS:G0121)
Insertion of spinal neurostimulator electrode array through skin (HCPCS:63650)
Colorectal cancer screening; colonoscopy on individual at high risk (HCPCS:G0105)
Insertion of spinal neurostimulator generator or receiver (HCPCS:63685)
Diagnostic exam of esophagus, stomach, and/or upper small bowel using a flexible endoscope (HCPCS:43235)
Injection beneath lining of large bowel using a flexible endoscope (HCPCS:45381)

The enumeration date for this NPI number is 6/28/2005 and was last updated on 10/23/2024.

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
1	261QA1903X	Clinic/Center	Ambulatory Surgical	EXEMPT FROM LICENSUR	CALIFORNIA	Yes

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
1	P00215810	OTHER	CALIFORNIA	MEDICARE RAILROAD CARRIER
2	05-C0001711	MEDICAID	CALIFORNIA
3	CA0300001807	OTHER	CALIFORNIA	MISC

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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