NPIMap

Organization Active NPI

Temecula Ca Endoscopy ASC LP

Doing business as Temecula Valley Endoscopy Center

  • Ambulatory Surgical Clinic/Center
  • Murrieta, CA
National Provider Identifier
1477527398
Registry record updated Sep 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X
License
250000810 Issued in CA
Legal business name
TEMECULA CA ENDOSCOPY ASC LP
Doing business as
Temecula Valley Endoscopy Center
Practice address
25150 Hancock Ave
Suite 208
Murrieta, CA 92562-5987
Phone
(951) 698-8805
Fax
(951) 698-8898
NPI assigned
Feb 15, 2006
Last updated
Sep 7, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 7, 2023

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

Authorized official

Name
Mr. Phillip A Clendenin
Title
President
Phone
(615) 665-1283

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ambulatory Surgical Clinic/Center 261QA1903X 250000810 CA Primary

Addresses

Primary practice location

25150 Hancock Ave
Suite 208
Murrieta, CA 92562-5987

Mailing address

25150 Hancock Ave
Suite 208
Murrieta, CA 92562-5987
Phone (951) 698-8805

Other identifiers 1

IdentifierTypeStateIssuer
0612336MedicaidCA

Other names 1

  • Temecula Valley 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
O20050512000397 CA Part B Supplier - Ambulatory Surgical Center 4981645678 Practice locations: Murrieta, CA

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
Temecula Ca Endoscopy ASC LP Dba United Surgery Center MurrietaCCN 05C0001713
Medicare certification status
ActiveFrom the Provider of Services file

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 42

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 42

NPI Registry JSON

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

{
    "created_epoch": "1139961600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1694044800000",
    "number": "1477527398",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "25150 HANCOCK AVE",
            "address_2": "SUITE 208",
            "city": "MURRIETA",
            "state": "CA",
            "postal_code": "925625987",
            "telephone_number": "951-698-8805",
            "fax_number": "951-698-8898"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25150 HANCOCK AVE",
            "address_2": "SUITE 208",
            "city": "MURRIETA",
            "state": "CA",
            "postal_code": "925625987",
            "telephone_number": "951-698-8805",
            "fax_number": "951-698-8898"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TEMECULA CA ENDOSCOPY ASC LP",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-02-15",
        "last_updated": "2023-09-07",
        "status": "A",
        "authorized_official_last_name": "CLENDENIN",
        "authorized_official_first_name": "PHILLIP",
        "authorized_official_middle_name": "A",
        "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": "250000810",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0612336",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Temecula Valley Endoscopy Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Murrieta, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 7, 2023; 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.