NPIMap

Organization Active NPI

Lewes de Endoscopy ASC LLC

  • Ambulatory Surgical Clinic/Center
  • Lewes, DE
National Provider Identifier
1386618783
Registry record updated Sep 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X
License
NONE REQUIRED Issued in DE
Legal business name
LEWES DE ENDOSCOPY ASC LLC
Doing business as
Seaside Endoscopy Pavilion
Practice address
34444 King Street Row
Suite 4a
Lewes, DE 19958-4787
Phone
(302) 644-3852
Fax
(302) 644-3854
NPI assigned
Feb 14, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 21, 2022

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

Authorized official

Name
Mr. Jeffrey Snodgrass
Title
President
Phone
(615) 665-1283

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ambulatory Surgical Clinic/Center 261QA1903X NONE REQUIRED DE Primary

Addresses

Primary practice location

34444 King Street Row
Suite 4a
Lewes, DE 19958-4787

Mailing address

1A Burton Hills Blvd
Attn: L&C
Nashville, TN 37215-6103
Phone (302) 644-3852

Other identifiers 1

IdentifierTypeStateIssuer
1000022272261QA1903NMedicaidDE

Other names 1

  • Seaside Endoscopy Pavilion Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20041202000427 DE Part B Supplier - Ambulatory Surgical Center 6608832597 Receives reassigned benefits from 3 practitioners
1 other NPI on this enrollment
Practice locations: Lewes, DE

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

Care Compare: Ambulatory surgical center

Medicare Care Compare
Listed as
Seaside Endoscopy PavilionCCN 08C0001011
Medicare certification status
ActiveFrom the Provider of Services file

National Provider Directory

National Provider Directory
Tax ID family
Lewes de Endoscopy ASC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

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": "1139875200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1663718400000",
    "number": "1386618783",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1A BURTON HILLS BLVD",
            "address_2": "ATTN: L&C",
            "city": "NASHVILLE",
            "state": "TN",
            "postal_code": "372156103",
            "telephone_number": "302-644-3852",
            "fax_number": "302-644-3854"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "34444 KING STREET ROW",
            "address_2": "SUITE 4A",
            "city": "LEWES",
            "state": "DE",
            "postal_code": "199584787",
            "telephone_number": "302-644-3852",
            "fax_number": "302-644-3854"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LEWES DE ENDOSCOPY ASC LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-02-14",
        "last_updated": "2022-09-21",
        "certification_date": "2022-09-21",
        "status": "A",
        "authorized_official_last_name": "SNODGRASS",
        "authorized_official_first_name": "JEFFREY",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "615-665-1283",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": "DE",
            "license": "NONE REQUIRED",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1000022272261QA1903N",
            "state": "DE"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Seaside Endoscopy Pavilion",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Seaside Endoscopy Pavilion",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Lewes, DE

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 21, 2022; 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.