NPIMap

Organization Active NPI

La Jolla Endoscopy Center LP

Doing business as La Jolla Endoscopy Center

  • Ambulatory Surgical Clinic/Center
  • La Jolla, CA
National Provider Identifier
1407829773
Registry record updated May 3, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X
License
080000443 Issued in CA
Legal business name
LA JOLLA ENDOSCOPY CENTER LP
Doing business as
La Jolla Endoscopy Center
Practice address
9850 Genesee Ave
Suite 980
La Jolla, CA 92037-1234
Phone
(858) 453-7525
Fax
(858) 453-5753
NPI assigned
Feb 8, 2006
Last updated
May 3, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 3, 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 080000443 CA Primary

Addresses

Primary practice location

9850 Genesee Ave
Suite 980
La Jolla, CA 92037-1234

Mailing address

9850 Genesee Ave
Suite 980
La Jolla, CA 92037-1234
Phone (858) 453-7525

Other identifiers 1

IdentifierTypeStateIssuer
5329026MedicaidCA

Other names 1

  • La Jolla Endoscopy Center Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20070723000905 CA Part B Supplier - Ambulatory Surgical Center 0648371419 Receives reassigned benefits from 5 practitioners
1 other NPI on this enrollment
Practice locations: La Jolla, CA

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
La Jolla Endoscopy CenterCCN 05C0001263
Medicare certification status
ActiveFrom the Provider of Services file

National Provider Directory

National Provider Directory
Tax ID family
La Jolla Jendoscopy Ctr2 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.

Member of 1

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

Member organizations 1

Organizations listed as members of this organization in the National Provider Directory.

Locations

9850 Genesee Ave
Ste 100
La Jolla, CA 92037

Practitioners & affiliated clinicians

Practitioners 5

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": "1139356800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1651536000000",
    "number": "1407829773",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9850 GENESEE AVE",
            "address_2": "SUITE 980",
            "city": "LA JOLLA",
            "state": "CA",
            "postal_code": "920371234",
            "telephone_number": "858-453-7525",
            "fax_number": "858-453-5753"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9850 GENESEE AVE",
            "address_2": "SUITE 980",
            "city": "LA JOLLA",
            "state": "CA",
            "postal_code": "920371234",
            "telephone_number": "858-453-7525",
            "fax_number": "858-453-5753"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LA JOLLA ENDOSCOPY CENTER LP",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-02-08",
        "last_updated": "2022-05-03",
        "certification_date": "2022-05-03",
        "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": "CA",
            "license": "080000443",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5329026",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "La Jolla Endoscopy Center",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "La Jolla Endoscopy Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in La Jolla, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 3, 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.