Memorial Hermann Endoscopy Center North Freeway LLC

Primary specialty

Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X

License

130220 Issued in TX

Legal business name

MEMORIAL HERMANN ENDOSCOPY CENTER NORTH FREEWAY LLC

Doing business as

Memorial Hermann Endoscopy Center North Loop

Practice address

1900 North Loop W
Ste 550
Houston, TX 77018-8100

Phone

(713) 457-2750

Fax

(713) 457-2751

NPI assigned

Jun 29, 2010

Last updated

Sep 5, 2024By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Peter Blach

Title

Officer/Authorized Official

Phone

(713) 343-0832

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Memorial Hermann Endoscopy Center North Loop Doing business as

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in TX

Enrollment records 1

Listed as

Memorial Hermann Endoscopy Center North LoopCCN 45C0001363

Medicare certification status

ActiveFrom the Provider of Services file

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Member of 2

Organizations this organization is a member of, according to the National Provider Directory.

• Baylor University Medical Center

  • Durable Medical Equipment & Medical Supplies
  • Dallas, TX
  • NPI 1518967231

  Member Of

  NPD member
• VHS San Antonio Partners LLC

  dba Baptist Health System

  • Psychiatric Hospital Unit
  • San Antonio, TX
  • NPI 1487633509

  Member Of

  NPD member

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Darshan P Anandu, M.D.

  • Gastroenterology Physician
  • Houston, TX
  • NPI 1487657680
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1277769600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1725494400000",
    "number": "1003127606",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14201 DALLAS PKWY",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752542916",
            "telephone_number": "713-457-2750",
            "fax_number": "713-457-2751"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1900 NORTH LOOP W",
            "address_2": "STE 550",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770188100",
            "telephone_number": "713-457-2750",
            "fax_number": "713-457-2751"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEMORIAL HERMANN ENDOSCOPY CENTER NORTH FREEWAY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-06-29",
        "last_updated": "2024-09-05",
        "certification_date": "2024-09-05",
        "status": "A",
        "authorized_official_last_name": "BLACH",
        "authorized_official_first_name": "PETER",
        "authorized_official_title_or_position": "OFFICER/AUTHORIZED OFFICIAL",
        "authorized_official_telephone_number": "713-343-0832"
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": "TX",
            "license": "130220",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2205007",
            "state": "TX"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://esmd.abilitynetwork.com:8291/gateway/documentsubmission/2_0/NhinService/XDRRequest_Service",
            "affiliation": "Y",
            "endpointDescription": "2.16.840.1.113883.3.667.2",
            "affiliationName": "Ability Network",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "CMS esMD eMDR",
            "address_1": "100 N 6th St Ste 900A",
            "city": "Minneapolis",
            "state": "MN",
            "country_code": "US",
            "postal_code": "554031516",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Memorial Hermann Endoscopy Center North Loop",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Memorial Hermann Endoscopy Center North Loop",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Memorial Hermann Community Benefit Corporation (Memorial Hermann Health Centers for Schools--Nimitz Clinic)
• Memorial Hermann Continuing Care Corporation (Memorial Hermann Continuing Care Hospital)
• Memorial Hermann Continuing Care Corporation (Memorial Hermann Spring Shadows Pines)
• Memorial Hermann Counseling Center
• Memorial Hermann Endoscopy & Surgery Center North Houston, LLC (North Houston Endoscopy & Surgery Center)
• Memorial Hermann Health System (MHHS NW Radiation Therapy)
• Memorial Hermann Health System (Children's Memorial Hermann Dialysis Center)
• Memorial Hermann Health System (Memorial Hermann Imaging Centers-Hedwig Village Center RR)
• Memorial Hermann Health System (Memorial Hermann Home Health)
• Memorial Hermann Health System (Memorial Hermann Outpatient Imaging-Southwest)

• Ambulatory Surgical Clinic/Center in Houston, TX
• Providers in Houston, TX by specialty
• Ambulatory Surgical Clinic/Center in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 5, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.