Organization Active NPI

South Perry Endoscopy PLLC

  • Ambulatory Surgical Clinic/Center
  • Spokane, WA
National Provider Identifier
1023507183
Registry record updated Jul 8, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X
Legal business name
SOUTH PERRY ENDOSCOPY PLLC
Practice address
907 S Perry St Ste 260
Spokane, WA 99202-3462
Phone
(509) 456-5433
NPI assigned
May 4, 2018
Organization subpart
Yes
Parent organization
SOUTH PERRY ENDOSCOPY PLLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jul 8, 2023

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

Authorized official

Name
Harold G PreiksaitisNPI 1962495283
Title
MD Owner
Phone
(509) 456-5433

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ambulatory Surgical Clinic/Center 261QA1903X Primary

Addresses

Primary practice location

907 S Perry St Ste 260
Spokane, WA 99202-3462

Mailing address

907 S Perry St Ste 260
Spokane, WA 99202-3462

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20171027000651 WA Part B Supplier - Ambulatory Surgical Center 3173830866 Receives reassigned benefits from 1 practitioner
1 other NPI on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Spokane, WA

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

Care Compare: Ambulatory surgical center

Medicare Care Compare
Listed as
South Perry Endoscopy PLLCCCN 50C0001321
Medicare certification status
ActiveFrom the Provider of Services file

National Provider Directory

National Provider Directory
Part of
South Perry Endoscopy PLLC

Locations

907 S Perry St
#202
Spokane, WA 99202
Phone (509) 868-8816

907 S Perry St
Ste 26
Spokane, WA 99202

105 W 8th Ave
Ste 400C
Spokane, WA 99204
Phone (509) 456-5433

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1525392000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1688774400000",
    "number": "1023507183",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "907 S PERRY ST STE 260",
            "city": "SPOKANE",
            "state": "WA",
            "postal_code": "992023462"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "907 S PERRY ST STE 260",
            "city": "SPOKANE",
            "state": "WA",
            "postal_code": "992023462",
            "telephone_number": "509-456-5433"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTH PERRY ENDOSCOPY PLLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "SOUTH PERRY ENDOSCOPY PLLC",
        "enumeration_date": "2018-05-04",
        "last_updated": "2023-07-08",
        "certification_date": "2023-07-08",
        "status": "A",
        "authorized_official_last_name": "PREIKSAITIS",
        "authorized_official_first_name": "HAROLD",
        "authorized_official_middle_name": "G",
        "authorized_official_title_or_position": "MD OWNER",
        "authorized_official_telephone_number": "509-456-5433"
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Spokane, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2023; 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.