Hazleton Endoscopy Center, Inc.
Organization Active NPI Ambulatory Surgical Clinic/Center · Hazle Township, PA
NPI 1043375702 · NPPES record last updated Dec 24, 2008
Key facts
- NPI
- 1043375702
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Ambulatory Surgical Clinic/Center 261QA1903X
- License
- 14601501 (PA)
- Legal business name
- HAZLETON ENDOSCOPY CENTER, INC.
- Practice address
- 10 Park Place
Hazle Township, PA 18202-9394 - Phone
- (570) 454-1400
- Fax
- (570) 454-2144
- NPI assigned
- Dec 23, 2006
- Organization subpart
- No
Authorized official
- Name
- Dr. Young Kul Yoo, M.D.
- Title
- President
- Phone
- (570) 454-1400
Practitioners 2
-
Michael A Yoder, MD
-
Alan Shienbaum, D.O.
Medicare Care Compare: Ambulatory surgical center
- Listed as
- Hazleton Endoscopy Center Inc
- Medicare certification status
- Active
Laboratory certificates & supplier records
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 39D1044078 | Hazleton Endoscopy Center Inc | Certificate of waiver | Aug 9, 2027 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in PA
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20090708000223 | PA | Part B Supplier - Ambulatory Surgical Center | 1951452721 |
Receives reassigned benefits from 2 practitioners Practice locations: Hazle Township, PA |
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Ambulatory Surgical Clinic/Center | 261QA1903X | 14601501 | PA | Yes |
Addresses
Primary practice location
10 Park Place
Hazle Township, PA 18202-9394
Mailing address
10 Park Place
Hazle Township, PA 18202-9394
Phone (570) 454-1400
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 2678733 | Other | PA | AETNA |
| 1007294940003 | Medicaid | PA |
Other providers in Hazle Township, PA
- Colleen Marie Haggerty-Barron
- Larry Gene Halye Jr.
- Jessica Hartz
- Edward Joseph Harvilla
- Hazleton Area SD
- Hazleton Eye Center, Inc.
- Hazleton Physical Therapy, LLC
- Darren Joseph Hohn
- Home Health Agency -Philadelphia, LLC
- Hope Within Massage Center
All providers in Hazle Township, PA · Ambulatory Surgical Clinic/Center in Pennsylvania
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 24, 2008. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.