Active NPI
Temecula Ca Endoscopy ASC LP
- Anesthesiology Physician
- Murrieta, CA
National Provider Identifier
1285863696
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Anesthesiology Physician
- Legal business name
- TEMECULA CA ENDOSCOPY ASC LP
- Practice address
- 25150 Hancock Ave
Suite 208
Murrieta, CA 92562-5987 - Phone
- (951) 698-8805
- Fax
- (951) 698-8898
- NPI assigned
- Jul 7, 2009
- Organization subpart
- No
NPPES NPI Registry
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) | Code | License | State | Primary |
|---|---|---|---|---|
| Anesthesiology Physician | 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 identifiers 8
| Identifier | Type | State | Issuer |
|---|---|---|---|
| AS308X | Other | CA | CRNA - SANDBERG |
| CH801Z | Other | CA | CRNA-PERRENOUD |
| BU941Y | Other | CA | CRNA - LUCAS |
| DB330Z | Other | CA | CRNA - FERGUSON |
| AZ149X | Other | CA | CRNA - MCNAMARA |
| CY651Z | Other | CA | CRNA - LYNN |
| BB070W | Other | CA | CRNA BJERK |
| CE284Y | Other | CA | CRNA - STALLMER |
Other names 1
- Temecula Valley Endoscopy Center
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CA
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| 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).
-
- Ambulatory Surgical Clinic/Center
- Murrieta, CA
- NPI 1477527398
4981645678
National Provider Directory
National Provider DirectoryPractitioners & affiliated clinicians
Practitioners 42
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Certified Registered Nurse Anesthetist
- Camp Pendleton, CA
- NPI 1164863692
CA
-
- Certified Registered Nurse Anesthetist
- Camp Pendleton, CA
- NPI 1316912090
CA
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": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CRNA - SANDBERG",
"identifier": "AS308X",
"state": "CA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CRNA-PERRENOUD",
"identifier": "CH801Z",
"state": "CA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CRNA - LUCAS",
"identifier": "BU941Y",
"state": "CA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CRNA - FERGUSON",
"identifier": "DB330Z",
"state": "CA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CRNA - MCNAMARA",
"identifier": "AZ149X",
"state": "CA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CRNA - LYNN",
"identifier": "CY651Z",
"state": "CA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CRNA BJERK",
"identifier": "BB070W",
"state": "CA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CRNA - STALLMER",
"identifier": "CE284Y",
"state": "CA"
}
],
"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.