East Bay Endoscopy Center LLC

Primary specialty

Endoscopy Clinic/CenterTaxonomy code 261QE0800X

Legal business name

EAST BAY ENDOSCOPY CENTER LLC

Practice address

109 Clock Tower Square
Portsmouth, RI 02871

Phone

(401) 421-8800

Fax

(401) 278-4070

NPI assigned

May 22, 2007

Organization subpart

No

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

Authorized official

Name

Jennifer Boyd Baldock

Title

Officer and Authorized Official

Phone

(615) 234-5954

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in RI

Enrollment records 1

Listed as

East Bay Endoscopy CenterCCN 41C0001013

Medicare certification status

ActiveFrom the Provider of Services file

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

CLIA laboratory certificates

Locations

Practitioners 1

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

• Thomas E. Sepe, MD

  • Gastroenterology Physician
  • Providence, RI
  • NPI 1508937889
  NPD

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

{
    "created_epoch": "1179792000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1753142400000",
    "number": "1235348335",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "33 STANIFORD ST",
            "city": "PROVIDENCE",
            "state": "RI",
            "postal_code": "029053105",
            "telephone_number": "401-421-8800",
            "fax_number": "401-278-4070"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "109 CLOCK TOWER SQUARE",
            "city": "PORTSMOUTH",
            "state": "RI",
            "postal_code": "02871",
            "telephone_number": "401-421-8800",
            "fax_number": "401-278-4070"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EAST BAY ENDOSCOPY CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-22",
        "last_updated": "2025-07-22",
        "certification_date": "2025-07-22",
        "status": "A",
        "authorized_official_last_name": "BALDOCK",
        "authorized_official_first_name": "JENNIFER",
        "authorized_official_middle_name": "BOYD",
        "authorized_official_title_or_position": "OFFICER AND AUTHORIZED OFFICIAL",
        "authorized_official_telephone_number": "615-234-5954"
    },
    "taxonomies": [
        {
            "code": "261QE0800X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Endoscopy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Dr. Misty Kosciusko Dba New Horizon Chiropractic & Wellness
• Shiana Nadine Dubois
• Emily Duffy
• Sara R. Duggan, LICSW
• Kara A Dunivin, COTA/L
• East Bay Psychiatry, LLC
• Eleanor T. Howard, LLC
• Brenda Diane Eline
• Eric M Johnsen DMD, Inc
• Daniel Erickson, LMHC

• Endoscopy Clinic/Center in Portsmouth, RI
• Providers in Portsmouth, RI by specialty
• Endoscopy Clinic/Center in Rhode Island

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 22, 2025; 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.