Chandler Endoscopy Ambulatory Surgery Center, LLC

Primary specialty

Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X

License

OSC514 Issued in AZ

Legal business name

CHANDLER ENDOSCOPY AMBULATORY SURGERY CENTER, LLC

Doing business as

Chandler Endoscopy Center

Practice address

2095 W Pecos Rd
Suite 1
Chandler, AZ 85224-5724

Phone

(480) 292-9795

Fax

(480) 292-9818

NPI assigned

Jan 20, 2012

Organization subpart

No

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

Authorized official

Name

Eric Boon

Title

Officer/Authorized Official

Phone

(480) 567-0269

Specialties & licenses 1

Addresses

Other names 1

• Chandler Endoscopy Center Doing business as

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in AZ

Enrollment records 1

Listed as

Chandler Endoscopy Ambulatory Surgery Center LLC Dba Chandler Endoscopy CenterCCN 03C0001279

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 3

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
• Dignity Health

  dba Woodland Healthcare Pharmacy

  • Community/Retail Pharmacy
  • Woodland, CA
  • NPI 1093830994

  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

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

{
    "created_epoch": "1327017600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1726617600000",
    "number": "1093086183",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2095 W PECOS RD",
            "address_2": "SUITE 1",
            "city": "CHANDLER",
            "state": "AZ",
            "postal_code": "852245724",
            "telephone_number": "480-292-9795",
            "fax_number": "480-292-9818"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2095 W PECOS RD",
            "address_2": "SUITE 1",
            "city": "CHANDLER",
            "state": "AZ",
            "postal_code": "852245724",
            "telephone_number": "480-292-9795",
            "fax_number": "480-292-9818"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHANDLER ENDOSCOPY AMBULATORY SURGERY CENTER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-01-20",
        "last_updated": "2024-09-18",
        "certification_date": "2024-09-18",
        "status": "A",
        "authorized_official_last_name": "BOON",
        "authorized_official_first_name": "ERIC",
        "authorized_official_title_or_position": "OFFICER/AUTHORIZED OFFICIAL",
        "authorized_official_telephone_number": "480-567-0269"
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": "AZ",
            "license": "OSC514",
            "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": "Chandler Endoscopy Center",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Chandler Endoscopy Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Chandler Dental PLC (Chandler Dental)
• Chandler Dentistry LLC
• Chandler Dermatology LTD
• Chandler Emergency Medical Group, LLC (Premier Emergency Medical Specialists)
• Chandler Endocrinology, LLC
• Chandler Endoscopy Center, L.L.C.
• Chandler Eye Center
• Chandler Eyecare LLC
• Chandler Fairview Partners LLC (Copper Creek Inn Memory Care)
• Chandler Family Chiropractic & Rehab, PLLC

• Ambulatory Surgical Clinic/Center in Chandler, AZ
• Providers in Chandler, AZ by specialty
• Ambulatory Surgical Clinic/Center in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 18, 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.