Staten Island GSC LLC

Primary specialty

Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X

Legal business name

STATEN ISLAND GSC LLC

Practice address

2043 Richmond Ave FL 1
Staten Island, NY 10314-3964

Phone

(718) 975-7574

NPI assigned

Feb 2, 2023

Organization subpart

No

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

Authorized official

Name

Dr. Alexander Brun, MDNPI 1164735072

Title

Vice President

Phone

(718) 450-4870

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NY

Enrollment records 1

Ambulatory surgical center certification: CCN 33C0001228

Legal name

Staten Island Endoscopy Center

Certification status

Active

Provider type (POS)

Ambulatory surgical center

Participating since

Nov 26, 2025

Last certification

Oct 29, 2025

Facility address

2043 Richmond Avenue
Staten Island, NY 10314

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

CLIA laboratory certificates

Locations

Practitioners 2

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

• Alexander Brun, MD

  • Gastroenterology Physician
  • Brooklyn, NY
  • NPI 1164735072
  NPD Authorized official
• Igor Grosman, D.O.

  • Gastroenterology Physician
  • Brooklyn, NY
  • NPI 1851506869
  NPD

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

{
    "created_epoch": "1675296000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1675296000000",
    "number": "1033815915",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2043 RICHMOND AVE FL 1",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103143964",
            "telephone_number": "718-975-7574"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2043 RICHMOND AVE FL 1",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103143964",
            "telephone_number": "718-975-7574"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STATEN ISLAND GSC LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-02-02",
        "last_updated": "2023-02-02",
        "certification_date": "2023-02-02",
        "status": "A",
        "authorized_official_last_name": "BRUN",
        "authorized_official_first_name": "ALEXANDER",
        "authorized_official_title_or_position": "VICE PRESIDENT",
        "authorized_official_telephone_number": "718-450-4870",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Ambulatory Surgical Clinic/Center in Staten Island, NY
• Providers in Staten Island, NY by specialty
• Ambulatory Surgical Clinic/Center in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 2, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
• 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.