Organization Active NPI

Gcsa Ambulatory Surgery Center, LLC

  • Ambulatory Surgical Clinic/Center
  • San Antonio, TX
National Provider Identifier
1225375587
Registry record updated Oct 7, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X
Legal business name
GCSA AMBULATORY SURGERY CENTER, LLC
Practice address
855 Proton Rd
San Antonio, TX 78258-4203
Phone
(210) 614-1234
Fax
(210) 614-0952
NPI assigned
Jan 7, 2013
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 7, 2024

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

Authorized official

Name
Peter Blach
Title
Officer / Authorized Official
Phone
(713) 343-0832

Specialties & licenses 1

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

Addresses

Primary practice location

855 Proton Rd
San Antonio, TX 78258-4203

Mailing address

4801 NW Loop 410 Ste 812
San Antonio, TX 78229-5347
Phone (210) 614-1234

Other names 1

  • Gastroenterology Consultants of San Antonio - Stone Oak Doing business as

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL https://esmd.abilitynetwork.com:8291/gateway/documentsubmission/2_0/NhinService/XDRRequest_Service Other Ability Network

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20130619000662 TX Part B Supplier - Ambulatory Surgical Center 9537308747 Practice locations: San Antonio, TX

Other NPIs with the same Medicare PAC ID 2

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

Care Compare: Ambulatory surgical center

Medicare Care Compare
Listed as
Gastroenterology Consultants of San Antonio NECCN 45C0001477
Medicare certification status
ActiveFrom the Provider of Services file

National Provider Directory

National Provider Directory
Tax ID family
Ability Network3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

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

Member of 2

Organizations this organization is a member of, according to the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1357516800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1728259200000",
    "number": "1225375587",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4801 NW LOOP 410 STE 812",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782295347",
            "telephone_number": "210-614-1234",
            "fax_number": "210-614-0952"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "855 PROTON RD",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782584203",
            "telephone_number": "210-614-1234",
            "fax_number": "210-614-0952"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GCSA AMBULATORY SURGERY CENTER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-01-07",
        "last_updated": "2024-10-07",
        "certification_date": "2024-10-07",
        "status": "A",
        "authorized_official_last_name": "BLACH",
        "authorized_official_first_name": "PETER",
        "authorized_official_title_or_position": "OFFICER / AUTHORIZED OFFICIAL",
        "authorized_official_telephone_number": "713-343-0832"
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": null,
            "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": "Gastroenterology Consultants of San Antonio - Stone Oak",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Gastroenterology Consultants of San Antonio - Stone Oak",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in San Antonio, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 7, 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.