Christiana Care Brinton Lake Endoscopy, LLC

Primary specialty

Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X

Legal business name

CHRISTIANA CARE BRINTON LAKE ENDOSCOPY, LLC

Practice address

500 Evergreen Dr Ste 15
Glen Mills, PA 19342-1032

Phone

(610) 619-7475

NPI assigned

Jun 16, 2025

Last updated

Jun 19, 2025By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Douglas Azar

Title

Director/Officer

Phone

(484) 678-8475

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in PA

Enrollment records 1

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1447146469. Details of each certification follow.

• CCN 39C0001399 Ambulatory surgical center · Active · Name & address match · Details

Ambulatory surgical center certification: CCN 39C0001399

Legal name

CHRISTIANA CARE BRINTON LAKE ENDOSCOPY LLC

Certification status

Active

Provider type (POS)

Ambulatory surgical center

Participating since

Sep 16, 2025

Last certification

Sep 16, 2025

Ownership / control type

Proprietary

Facility address

500 Evergreen Drive Suite 15
Glen Mills, PA 19342

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.

• Christiana Care Pennsylvania Inc

  dba CCHS Therapy Services PA

  • Physical Therapist
  • Chadds Ford, PA
  • NPI 1356180681

  Member Of

  NPD member

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

{
    "created_epoch": "1750032000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1750291200000",
    "number": "1447146469",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "500 EVERGREEN DR STE 15",
            "city": "GLEN MILLS",
            "state": "PA",
            "postal_code": "193421032"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 EVERGREEN DR STE 15",
            "city": "GLEN MILLS",
            "state": "PA",
            "postal_code": "193421032",
            "telephone_number": "610-619-7475"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHRISTIANA CARE BRINTON LAKE ENDOSCOPY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-06-16",
        "last_updated": "2025-06-19",
        "certification_date": "2025-06-19",
        "status": "A",
        "authorized_official_last_name": "AZAR",
        "authorized_official_first_name": "DOUGLAS",
        "authorized_official_title_or_position": "DIRECTOR/OFFICER",
        "authorized_official_telephone_number": "484-678-8475"
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Francien Chenoweth, PSY.D
• Children's Hospital of Philadelphia (Urgent Care Brandywine Valley)
• Children's Hospital of Philadelphia (Care Network Chadds Ford)
• David Chiplonia, DPT
• Christiana Care Brinton Lake ASC, LLC
• Christiana Care Pennsylvania Inc (CCHS Gastroenterology PA)
• Christiana Care Pennsylvania Inc
• Christiana Care Pennsylvania Inc (CCHS Pulmonary Practice PA)
• Chronic Condition Recovery Center, Inc
• Christopher Clark, OTR/L

• Ambulatory Surgical Clinic/Center in Glen Mills, PA
• Providers in Glen Mills, PA by specialty
• Ambulatory Surgical Clinic/Center in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 19, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
• 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.