Organization Active NPI

Endoscopic Ambulatory Specialty Center of Bay Ridge Inc

  • Ambulatory Surgical Clinic/Center
  • Brooklyn, NY
National Provider Identifier
1164516084
Registry record updated Jul 6, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X
Legal business name
ENDOSCOPIC AMBULATORY SPECIALTY CENTER OF BAY RIDGE INC
Practice address
7601 4TH Ave
Suite 1a
Brooklyn, NY 11209-3207
Phone
(718) 745-0623
Fax
(718) 745-8091
NPI assigned
Oct 3, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 6, 2017

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

Authorized official

Name
Miss Anila Hoxha
Title
Executive Vice President
Phone
(718) 745-0623

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207L00000X
Ambulatory Surgical Clinic/Center 261QA1903X Primary

Addresses

Primary practice location

7601 4TH Ave
Suite 1a
Brooklyn, NY 11209-3207

Mailing address

7601 4TH Ave
Suite 1a
Brooklyn, NY 11209-3207
Phone (718) 745-0623

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20120123000496 NY Part B Supplier - Ambulatory Surgical Center 3072780659 Practice locations: Brooklyn, NY

Care Compare: Ambulatory surgical center

Medicare Care Compare
Listed as
Endoscopic Ambulatory Specialty Center of Bay Ridge IncCCN 33C0001071
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
33D2117525Endoscopic Ambulatory Specialty Center of Bay7601 4TH Avenue Suite 1a, Brooklyn, NY 11209Certificate of waiverMar 26, 2027

National Provider Directory

National Provider Directory

Locations

7601 4th Ave
Ste 1
Brooklyn, NY 11209

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1159833600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1499299200000",
    "number": "1164516084",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7601 4TH AVE",
            "address_2": "SUITE 1A",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112093207",
            "telephone_number": "718-745-0623",
            "fax_number": "718-745-8091"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7601 4TH AVE",
            "address_2": "SUITE 1A",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112093207",
            "telephone_number": "718-745-0623",
            "fax_number": "718-745-8091"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ENDOSCOPIC AMBULATORY SPECIALTY CENTER OF BAY RIDGE INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-03",
        "last_updated": "2017-07-06",
        "status": "A",
        "authorized_official_last_name": "HOXHA",
        "authorized_official_first_name": "ANILA",
        "authorized_official_title_or_position": "EXECUTIVE VICE PRESIDENT",
        "authorized_official_telephone_number": "718-745-0623",
        "authorized_official_name_prefix": "Miss"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Anesthesiology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 6, 2017; 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.