NPIMap

Organization Active NPI

Temecula Ca Endoscopy ASC LP

Doing business as Temecula Valley Endoscopy Center

  • Anesthesiology Physician
  • Murrieta, CA
National Provider Identifier
1285863696
Registry record updated Sep 27, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
Legal business name
TEMECULA CA ENDOSCOPY ASC LP
Doing business as
Temecula Valley Endoscopy Center
Practice address
25150 Hancock Ave
Suite 208
Murrieta, CA 92562-5987
Phone
(951) 698-8805
Fax
(951) 698-8898
NPI assigned
Jul 7, 2009
Last updated
Sep 27, 2018By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 27, 2018

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

Authorized official

Name
Kenneth Jones
Title
Director of Business Operations
Phone
(951) 698-8805

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207L00000X Primary

Addresses

Primary practice location

25150 Hancock Ave
Suite 208
Murrieta, CA 92562-5987

Mailing address

25150 Hancock Ave
Suite 208
Murrieta, CA 92562-5987
Phone (951) 698-8805

Other names 1

  • Temecula Valley 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
O20090730000041 CA Part B Supplier - Clinic/Group Practice 4981645678 Receives reassigned benefits from 40 practitioners
Practice locations: Murrieta, CA

Other NPIs with the same Medicare PAC ID 1

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

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 42

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 42

NPI Registry JSON

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

{
    "created_epoch": "1246924800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1538006400000",
    "number": "1285863696",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "25150 HANCOCK AVE",
            "address_2": "SUITE 208",
            "city": "MURRIETA",
            "state": "CA",
            "postal_code": "925625987",
            "telephone_number": "951-698-8805",
            "fax_number": "951-698-8898"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25150 HANCOCK AVE",
            "address_2": "SUITE 208",
            "city": "MURRIETA",
            "state": "CA",
            "postal_code": "925625987",
            "telephone_number": "951-698-8805",
            "fax_number": "951-698-8898"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TEMECULA CA ENDOSCOPY ASC LP",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-07-07",
        "last_updated": "2018-09-27",
        "status": "A",
        "authorized_official_last_name": "JONES",
        "authorized_official_first_name": "KENNETH",
        "authorized_official_title_or_position": "DIRECTOR OF BUSINESS OPERATIONS",
        "authorized_official_telephone_number": "951-698-8805"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Anesthesiology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Temecula Valley Endoscopy Center",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Temecula Valley Endoscopy Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Murrieta, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 27, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.