Coastal Endo, LLC

Primary specialty

Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X

Legal business name

COASTAL ENDO, LLC

Doing business as

Coastal Endoscopy Center

Practice address

175 Gunning River Rd Unit 4
Barnegat, NJ 08005-1436

Phone

(609) 698-0700

Fax

(609) 698-0777

NPI assigned

Sep 19, 2018

Last updated

Oct 4, 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

Jonathan Bailey

Title

Officer/Authorized Oficial

Phone

(203) 609-1168

Specialties & licenses 1

Addresses

Other names 1

• COASTAL ENDOSCOPY CENTER Doing business as

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in NJ

Enrollment records 1

Listed as

Coastal Endo LLCCCN 31C0001261

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.

• Brian Wolfman, M.D., MSC

  • Internal Medicine Physician
  • Brick, NJ
  • NPI 1336309673
  NPD (past)

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

{
    "created_epoch": "1537315200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1728000000000",
    "number": "1063996734",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "175 GUNNING RIVER RD UNIT 4",
            "city": "BARNEGAT",
            "state": "NJ",
            "postal_code": "080051436",
            "telephone_number": "609-698-0700",
            "fax_number": "609-698-0777"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "175 GUNNING RIVER RD UNIT 4",
            "city": "BARNEGAT",
            "state": "NJ",
            "postal_code": "080051436",
            "telephone_number": "609-698-0700",
            "fax_number": "609-698-0777"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COASTAL ENDO, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-09-19",
        "last_updated": "2024-10-04",
        "certification_date": "2024-10-04",
        "status": "A",
        "authorized_official_last_name": "BAILEY",
        "authorized_official_first_name": "JONATHAN",
        "authorized_official_title_or_position": "OFFICER/AUTHORIZED OFICIAL",
        "authorized_official_telephone_number": "203-609-1168"
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "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": "COASTAL ENDOSCOPY CENTER",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "COASTAL ENDOSCOPY CENTER",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Sabrina Casares, PT, DPT
• Cedar Bridge Pediatrics
• Gregory James Cheeseman Jr., PT, DPT
• Juliana Maria Claps, PSYD
• Ashlee Clarke, PHARM.D.
• Coastal Endoscopy Center, LLC
• Christina Cohen
• Jessica Collins, REGISTERED NURSE
• Jessica Comerford
• Community Options, Inc

• Ambulatory Surgical Clinic/Center in Barnegat, NJ
• Providers in Barnegat, NJ by specialty
• Ambulatory Surgical Clinic/Center in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 4, 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.