Organization Active NPI

Three Rivers Endoscopy Center, Inc.

  • Ambulatory Surgical Clinic/Center
  • Moon Township, PA
National Provider Identifier
1386602332
Registry record updated Feb 9, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X
License
391061 Issued in PA
Legal business name
THREE RIVERS ENDOSCOPY CENTER, INC.
Practice address
725 Cherrington Parkway
Ste 101
Moon Township, PA 15108-4305
Phone
(412) 262-1000
Fax
(412) 262-4607
NPI assigned
May 1, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 9, 2017

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

Authorized official

Name
Dr. Lester E Stine, M.D.NPI 1184606410
Title
President and Medical Director
Phone
(412) 262-1000

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ambulatory Surgical Clinic/Center 261QA1903X 391061 PA Primary

Addresses

Primary practice location

725 Cherrington Parkway
Ste 101
Moon Township, PA 15108-4305

Mailing address

725 Cherrington Parkway
Ste 101
Moon Township, PA 15108-4305
Phone (412) 262-1000

Other identifiers 1

IdentifierTypeStateIssuer
001652309MedicaidPA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20120529000225 PA Part B Supplier - Ambulatory Surgical Center 1052574167 Practice locations: Moon Township, PA

Care Compare: Ambulatory surgical center

Medicare Care Compare
Listed as
Three Rivers Endoscopy Center IncCCN 39C0001061
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
39D0989426Three Rivers Endoscopy Center725 Cherrington Parkway Suite 101, Moon Township, PA 15108Certificate of waiverJul 25, 2027

National Provider Directory

National Provider Directory

Locations

725 Cherrington Pkwy
Ste 101
Moon Township, PA 15108
Phone (412) 262-1000

725 Cherrington Pkwy
#101
Moon Township, PA 15108
Phone (412) 262-1000

Practitioners & affiliated clinicians

Practitioners 3

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

NPI Registry JSON

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

{
    "created_epoch": "1146441600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1486598400000",
    "number": "1386602332",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "725 CHERRINGTON PARKWAY",
            "address_2": "STE 101",
            "city": "MOON TOWNSHIP",
            "state": "PA",
            "postal_code": "151084305",
            "telephone_number": "412-262-1000",
            "fax_number": "412-262-4607"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "725 CHERRINGTON PARKWAY",
            "address_2": "STE 101",
            "city": "MOON TOWNSHIP",
            "state": "PA",
            "postal_code": "151084305",
            "telephone_number": "412-262-1000",
            "fax_number": "412-262-4607"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THREE RIVERS ENDOSCOPY CENTER, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-01",
        "last_updated": "2017-02-09",
        "status": "A",
        "authorized_official_last_name": "STINE",
        "authorized_official_first_name": "LESTER",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "PRESIDENT AND MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "412-262-1000",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": "PA",
            "license": "391061",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "001652309",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Moon Township, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 9, 2017; 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.