NPIMap

Organization Active NPI

Gastroenterology Specialists Inc

Doing business as Endoscopy Center

  • Ambulatory Surgical Clinic/Center
  • Canton, OH
National Provider Identifier
1447231287
Registry record updated Jan 14, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X
Legal business name
GASTROENTEROLOGY SPECIALISTS INC
Doing business as
Endoscopy Center
Practice address
2726 Fulton Dr NW
Canton, OH 44718-3506
Phone
(330) 455-5011
Fax
(330) 588-7127
NPI assigned
Nov 9, 2005
Last updated
Jan 14, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 14, 2021

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

Authorized official

Name
Ana M Theisen
Title
Practice Administrator
Phone
(330) 455-5011

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinic/Center 261Q00000X 0725AS OH
Ambulatory Surgical Clinic/Center 261QA1903X Primary

Addresses

Primary practice location

2726 Fulton Dr NW
Canton, OH 44718-3506

Mailing address

2726 Fulton Dr NW
Cantan, OH 44718-3506
Phone (330) 455-5011

Other identifiers 4

IdentifierTypeStateIssuer
P00132061OtherOHMEDICARE RAILROAD
000000157479OtherOHANTHEM BCBS
0842333MedicaidOH
8467319OtherOHAETNA

Other names 1

  • Endoscopy Center Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040108000837 OH Part B Supplier - Ambulatory Surgical Center 5991604860 Practice locations: Canton, OH

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Care Compare: Ambulatory surgical center

Medicare Care Compare
Listed as
Gastroenterology Specialists IncCCN 36C0001033
Medicare certification status
ActiveFrom the Provider of Services file

National Provider Directory

National Provider Directory

Member organizations 1

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

Interoperability endpoints

  • FHIR API: https://a8580225-25d6-4812-a463-58e49a80f214.gastro.prod.fhir.ema-api.com/fhir/r4/

Practitioners & affiliated clinicians

Practitioners 20

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.

View all 20

NPI Registry JSON

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

{
    "created_epoch": "1131494400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1610582400000",
    "number": "1447231287",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2726 FULTON DR NW",
            "city": "CANTAN",
            "state": "OH",
            "postal_code": "447183506",
            "telephone_number": "330-455-5011",
            "fax_number": "330-588-7127"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2726 FULTON DR NW",
            "city": "CANTON",
            "state": "OH",
            "postal_code": "447183506",
            "telephone_number": "330-455-5011",
            "fax_number": "330-588-7127"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GASTROENTEROLOGY SPECIALISTS INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-11-09",
        "last_updated": "2021-01-14",
        "certification_date": "2021-01-14",
        "status": "A",
        "authorized_official_last_name": "THEISEN",
        "authorized_official_first_name": "ANA",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "PRACTICE ADMINISTRATOR",
        "authorized_official_telephone_number": "330-455-5011"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "OH",
            "license": "0725AS",
            "primary": false
        },
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RAILROAD",
            "identifier": "P00132061",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM BCBS",
            "identifier": "000000157479",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0842333",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "8467319",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Endoscopy Center",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Endoscopy Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Canton, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 14, 2021; 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.