NPIMap

Organization Active NPI

San Luis Obispo Ca Endoscopy ASC LP

  • Ambulatory Surgical Clinic/Center
  • Templeton, CA
National Provider Identifier
1184699241
Registry record updated Jun 22, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X
License
050000582 Issued in CA
Legal business name
SAN LUIS OBISPO CA ENDOSCOPY ASC LP
Doing business as
Templeton Endoscopy Center
Practice address
1320 Las Tablas Rd
Suite a
Templeton, CA 93465-9711
Phone
(805) 434-9950
Fax
(805) 434-9952
NPI assigned
Feb 22, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 22, 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 050000582 CA Primary

Addresses

Primary practice location

1320 Las Tablas Rd
Suite a
Templeton, CA 93465-9711

Mailing address

1320 Las Tablas Rd
Suite a
Templeton, CA 93465-9711
Phone (805) 434-9950

Other identifiers 1

IdentifierTypeStateIssuer
SUR01662FMedicaidCA

Other names 1

  • Templeton Endoscopy Center Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20050805000489 CA Part B Supplier - Ambulatory Surgical Center 7911936307 Practice locations: Templeton, CA

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Care Compare: Ambulatory surgical center

Medicare Care Compare
Listed as
Templeton Endoscopy CenterCCN 05C0001662
Medicare certification status
ActiveFrom the Provider of Services file

National Provider Directory

National Provider Directory
Tax ID family
San Luis Obispo Ca Endoscopy ASC LP2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1140566400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1655856000000",
    "number": "1184699241",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1320 LAS TABLAS RD",
            "address_2": "SUITE A",
            "city": "TEMPLETON",
            "state": "CA",
            "postal_code": "934659711",
            "telephone_number": "805-434-9950",
            "fax_number": "805-434-9952"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1320 LAS TABLAS RD",
            "address_2": "SUITE A",
            "city": "TEMPLETON",
            "state": "CA",
            "postal_code": "934659711",
            "telephone_number": "805-434-9950",
            "fax_number": "805-434-9952"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SAN LUIS OBISPO CA ENDOSCOPY ASC LP",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-02-22",
        "last_updated": "2022-06-22",
        "certification_date": "2022-06-22",
        "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": "CA",
            "license": "050000582",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "SUR01662F",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Templeton Endoscopy Center",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Templeton Endoscopy Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Templeton, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 22, 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.