East Bay Endoscopy Center L P

Primary specialty

Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X

Legal business name

EAST BAY ENDOSCOPY CENTER L P

Practice address

5858 Horton St
Ste 100
Emeryville, CA 94608-2007

Phone

(510) 654-4554

Fax

(510) 654-4594

NPI assigned

Jun 21, 2005

Organization subpart

No

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

Authorized official

Name

Bradley Heaton

Title

Ceo

Phone

(916) 566-4907

Specialties & licenses 1

Addresses

Other identifiers 4

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Listed as

East Bay Endoscopy Center LPCCN 05C0001463

Medicare certification status

ActiveFrom the Provider of Services file

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

CLIA laboratory certificates

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

• Sutter Bay Medical Foundation

  • Clinical Medical Laboratory
  • Palo Alto, CA
  • NPI 1295459246

  Member Of

  NPD member

Locations

Practitioners 1

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

• Michael Silpa, M.D.

  • Specialist
  • Berkeley, CA
  • NPI 1679684195
  NPD (past)

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

{
    "created_epoch": "1119312000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1714089600000",
    "number": "1396741807",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5858 HORTON ST",
            "address_2": "SUITE 100",
            "city": "EMERYVILLE",
            "state": "CA",
            "postal_code": "946082006",
            "telephone_number": "510-654-4554"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5858 HORTON ST",
            "address_2": "STE 100",
            "city": "EMERYVILLE",
            "state": "CA",
            "postal_code": "946082007",
            "telephone_number": "510-654-4554",
            "fax_number": "510-654-4594"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EAST BAY ENDOSCOPY CENTER L P",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-06-21",
        "last_updated": "2024-04-26",
        "certification_date": "2024-04-26",
        "status": "A",
        "authorized_official_last_name": "HEATON",
        "authorized_official_first_name": "BRADLEY",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "916-566-4907"
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": "CA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AAAHC ORGANIZATION ID",
            "identifier": "20889",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD OF CA",
            "identifier": "ZZZH0112Z",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "AURO1463F",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "140000597",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Daniel Clark Drewry, MD
• Lonisha Duchine
• Simran Dulku
• Staci E Dumas, PA-C
• George Detroit Dunwood Jr.
• East Bay Lactation Associates LLC
• Xitiana Edgerton
• Jason Elcock
• Esther Elenes
• Emery Unified School District

• Ambulatory Surgical Clinic/Center in Emeryville, CA
• Providers in Emeryville, CA by specialty
• Ambulatory Surgical Clinic/Center in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 26, 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.