NPIMap

Organization Active NPI

East Valley Endoscopy LLC

  • Ambulatory Surgical Clinic/Center
  • Mesa, AZ
National Provider Identifier
1164414447
Registry record updated Sep 12, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X
License
OSC3368 Issued in AZ
Legal business name
EAST VALLEY ENDOSCOPY LLC
Practice address
6020 E Arbor Ave
Suite 105
Mesa, AZ 85206-6102
Phone
(480) 830-2005
Fax
(480) 830-2405
NPI assigned
Aug 22, 2005
Last updated
Sep 12, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 12, 2022

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

Authorized official

Name
Mr. Jeffrey Snodgrass
Title
President
Phone
(615) 665-1283

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ambulatory Surgical Clinic/Center 261QA1903X OSC3368 AZ Primary

Addresses

Primary practice location

6020 E Arbor Ave
Suite 105
Mesa, AZ 85206-6102

Mailing address

1A Burton Hills Blvd # L&C
Nashville, TN 37215-6187
Phone (615) 665-1283

Other identifiers 11

IdentifierTypeStateIssuer
874634OtherAZUSA/MCO
IZ9438OtherAZHEALTHNET
2047910OtherAZFIRST HEALTH NETWORK
5166126-001OtherAZCIGNA
5441198OtherAZCCN
AZ0208590OtherAZTRIWEST
68-03446OtherAZEVERCARE CHOICE
AZ0208590OtherAZBLUE CROSS BLUE SHEILD
0020884OtherAZPHYSICIANHEALTHORGANIZATI
769862OtherAZAHCCCS
A-133702OtherAZMULTIPLAN

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040428000783 AZ Part B Supplier - Ambulatory Surgical Center 5193712511 Practice locations: Mesa, AZ

Care Compare: Ambulatory surgical center

Medicare Care Compare
Listed as
East Valley EndoscopyCCN 03C0001260
Medicare certification status
ActiveFrom the Provider of Services file

Laboratory certificates & supplier records

Derived by NPIMap

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

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
03D1007506East Valley Endoscopy6020 E Arbor Ave Suite 105, Mesa, AZ 85206Certificate of waiverDec 18, 2026

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 72

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.

View all 72

NPI Registry JSON

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

{
    "created_epoch": "1124668800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1662940800000",
    "number": "1164414447",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1A BURTON HILLS BLVD # L&C",
            "city": "NASHVILLE",
            "state": "TN",
            "postal_code": "372156187",
            "telephone_number": "615-665-1283",
            "fax_number": "615-234-1720"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6020 E ARBOR AVE",
            "address_2": "SUITE 105",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852066102",
            "telephone_number": "480-830-2005",
            "fax_number": "480-830-2405"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EAST VALLEY ENDOSCOPY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-08-22",
        "last_updated": "2022-09-12",
        "certification_date": "2022-09-12",
        "status": "A",
        "authorized_official_last_name": "SNODGRASS",
        "authorized_official_first_name": "JEFFREY",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "615-665-1283",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": "AZ",
            "license": "OSC3368",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "USA/MCO",
            "identifier": "874634",
            "state": "AZ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTHNET",
            "identifier": "IZ9438",
            "state": "AZ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FIRST HEALTH NETWORK",
            "identifier": "2047910",
            "state": "AZ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA",
            "identifier": "5166126-001",
            "state": "AZ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CCN",
            "identifier": "5441198",
            "state": "AZ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TRIWEST",
            "identifier": "AZ0208590",
            "state": "AZ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "EVERCARE CHOICE",
            "identifier": "68-03446",
            "state": "AZ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHEILD",
            "identifier": "AZ0208590",
            "state": "AZ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PHYSICIANHEALTHORGANIZATI",
            "identifier": "0020884",
            "state": "AZ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AHCCCS",
            "identifier": "769862",
            "state": "AZ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MULTIPLAN",
            "identifier": "A-133702",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Mesa, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 12, 2022; 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.