Organization Active NPI

Freehold Endoscopy Associates, LLC

Doing business as Endoscopy Center of Monmouth County

  • Ambulatory Surgical Clinic/Center
  • Freehold, NJ
National Provider Identifier
1447320213
Registry record updated Apr 28, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X
Legal business name
FREEHOLD ENDOSCOPY ASSOCIATES, LLC
Doing business as
Endoscopy Center of Monmouth County
Practice address
222 Schanck Road
Ste 100
Freehold, NJ 07728
Phone
(732) 845-0990
Fax
(732) 845-0088
NPI assigned
Nov 9, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 28, 2011

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

Authorized official

Name
Dr. Robert R Blank, MD
Title
Medical Director
Phone
(732) 845-0990

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ambulatory Surgical Clinic/Center 261QA1903X Primary

Addresses

Primary practice location

222 Schanck Road
Ste 100
Freehold, NJ 07728

Mailing address

222 Schanck Road
Ste 100
Freehold, NJ 07728
Phone (732) 845-0990

Other names 1

  • Endoscopy Center of Monmouth County Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040727001575 NJ Part B Supplier - Ambulatory Surgical Center 9234109398 Practice locations: Freehold, NJ

Care Compare: Ambulatory surgical center

Medicare Care Compare
Listed as
Freehold Endoscopy Associates LLCCCN 31C0001033
Medicare certification status
ActiveFrom the Provider of Services file

Laboratory certificates & supplier records

Derived by NPIMap

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

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
31D1022676Endoscopy Center of Monmouth County222 Schanck Road, Freehold, NJ 07728Certificate of waiverFeb 23, 2028

National Provider Directory

National Provider Directory

Member of 1

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

Locations

222 Schanck Rd
Ste 302
Freehold, NJ 07728
Phone (732) 577-1999

222 Schanck Rd
Ste 100
Freehold, NJ 07728
Phone (732) 845-0900

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": "1163030400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1303948800000",
    "number": "1447320213",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "222 SCHANCK ROAD",
            "address_2": "STE 100",
            "city": "FREEHOLD",
            "state": "NJ",
            "postal_code": "07728",
            "telephone_number": "732-845-0990",
            "fax_number": "732-845-0088"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "222 SCHANCK ROAD",
            "address_2": "STE 100",
            "city": "FREEHOLD",
            "state": "NJ",
            "postal_code": "07728",
            "telephone_number": "732-845-0990",
            "fax_number": "732-845-0088"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FREEHOLD ENDOSCOPY ASSOCIATES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-09",
        "last_updated": "2011-04-28",
        "status": "A",
        "authorized_official_last_name": "BLANK",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "732-845-0990",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Endoscopy Center of Monmouth County",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Freehold, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 28, 2011; 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.