Main Line PA Endoscopy ASC LP

Primary specialty

Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X

License

16701501 Issued in PA

Legal business name

MAIN LINE PA ENDOSCOPY ASC LP

Practice address

333 E City Line Ave
Two Bala Plaza, Suite 30
Bala Cynwyd, PA 19004-1501

Phone

(610) 644-7274

Fax

(610) 644-7276

NPI assigned

Sep 22, 2006

Organization subpart

No

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

Addresses

Other identifiers 1

Other names 1

• Main Line Endoscopy Center Bala Cynwyd Doing business as

Listed as

Main Line Endoscopy Center EastCCN 39C0001149

Medicare certification status

Terminated Voluntary: merger or closure, Sep 4, 2024From the Provider of Services file

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

{
    "created_epoch": "1158883200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1709769600000",
    "number": "1235239054",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1A BURTON HILLS BLVD # L&C",
            "address_2": "STE 300",
            "city": "NASHVILLE",
            "state": "TN",
            "postal_code": "372156187",
            "telephone_number": "615-240-3820",
            "fax_number": "615-234-1720"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "333 E CITY LINE AVE",
            "address_2": "TWO BALA PLAZA, SUITE 30",
            "city": "BALA CYNWYD",
            "state": "PA",
            "postal_code": "190041501",
            "telephone_number": "610-644-7274",
            "fax_number": "610-644-7276"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MAIN LINE PA ENDOSCOPY ASC LP",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-22",
        "last_updated": "2024-03-07",
        "certification_date": "2024-03-07",
        "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": "PA",
            "license": "16701501",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00478537",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Main Line Endoscopy Center Bala Cynwyd",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Angelika Magner, OD
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• Mainline Health Associates
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• Ambulatory Surgical Clinic/Center in Bala Cynwyd, PA
• Providers in Bala Cynwyd, PA by specialty
• Ambulatory Surgical Clinic/Center in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• 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.