Organization Active NPI

Gcsa Ambulatory Surgery Center, LLC

Doing business as Gastroenterology Consultants of San Antonio NE

  • Ambulatory Surgical Clinic/Center
  • Live Oak, TX
National Provider Identifier
1306263983
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
Doing business as
Gastroenterology Consultants of San Antonio NE
Practice address
12850 Toepperwein Rd.
Live Oak, TX 78233
Phone
(210) 614-1234
Fax
(210) 614-0952
NPI assigned
Mar 21, 2014
Last updated
Oct 7, 2024By the provider in NPPES
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

12850 Toepperwein Rd.
Live Oak, TX 78233

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 NE 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
O20140519001487 TX Part B Supplier - Ambulatory Surgical Center 9537308747 Practice locations: Live Oak, 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 Stone CreekCCN 45C0001567
Medicare certification status
ActiveFrom the Provider of Services file

Laboratory certificates & supplier records

Derived by NPIMap

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

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
45D2079862Gastroenterology Consultants of San Antonio NE12850 Toepperwein Road, San Antonio, TX 78233Certificate of waiverJun 24, 2028

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.

Locations

8415 Datapoint Dr
Ste 1000
San Antonio, TX 78229
Phone 2106141234 ext. 325

Practitioners & affiliated clinicians

Practitioners 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1395360000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1728259200000",
    "number": "1306263983",
    "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": "12850 TOEPPERWEIN RD.",
            "city": "LIVE OAK",
            "state": "TX",
            "postal_code": "78233",
            "telephone_number": "210-614-1234",
            "fax_number": "210-614-0952"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GCSA AMBULATORY SURGERY CENTER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-03-21",
        "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 NE",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Gastroenterology Consultants of San Antonio NE",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Live Oak, 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.