Endoscopy Center of South Sacramento, LLC

Primary specialty

Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X

Legal business name

ENDOSCOPY CENTER OF SOUTH SACRAMENTO, LLC

Doing business as

ENDOSCOPY CENTER OF SOUTH SACRAMENTO

Practice address

8120 Timberlake Way Ste 103
Sacramento, CA 95823-5413

Phone

(916) 681-2350

Fax

(916) 681-2370

NPI assigned

Sep 6, 2018

Organization subpart

No

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

Authorized official

Name

Eric Boon

Title

Authorized Official / Officer

Phone

(480) 567-0259

Specialties & licenses 1

Addresses

Other names 1

• ENDOSCOPY CENTER OF SOUTH SACRAMENTO Doing business as

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Listed as

Endoscopy Center of South SacramentoCCN 05C0001604

Medicare certification status

ActiveFrom the Provider of Services file

Member of 4

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

• Dignity Health Medical Foundation

  • Multi-Specialty Clinic/Center
  • Redding, CA
  • NPI 1912288432

  Member Of

  NPD member
• Baylor University Medical Center

  • General Acute Care Hospital
  • Dallas, TX
  • NPI 1447250253

  Member Of

  NPD member
• Dignity Health

  • Neurological Surgery Physician
  • Henderson, NV
  • NPI 1720358039

  Member Of

  NPD member
• VHS San Antonio Partners LLC

  • Psychiatric Hospital Unit
  • San Antonio, TX
  • NPI 1487633509

  Member Of

  NPD member

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Rekha Cheruvattath, MD

  • Gastroenterology Physician
  • Sacramento, CA
  • NPI 1891779740
  NPD (past)
• Rana Khan, MD

  • Surgery Physician
  • Sacramento, CA
  • NPI 1164976585
  NPD (past)
• Rana Mahfooz Ali Khan, M.D.

  • Gastroenterology Physician
  • Sacramento, CA
  • NPI 1346464765
  NPD (past)
• Thimmaiah Ganapathi Theethira, M.D.,

  • Gastroenterology Physician
  • Sacramento, CA
  • NPI 1225284359
  NPD (past)

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

{
    "created_epoch": "1536192000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1785888000000",
    "number": "1487136412",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15305 DALLAS PKWY STE 1600",
            "city": "ADDISON",
            "state": "TX",
            "postal_code": "750016491",
            "telephone_number": "972-763-3893",
            "fax_number": "972-692-6745"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8120 TIMBERLAKE WAY STE 103",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958235413",
            "telephone_number": "916-681-2350",
            "fax_number": "916-681-2370"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ENDOSCOPY CENTER OF SOUTH SACRAMENTO, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-09-06",
        "last_updated": "2026-08-05",
        "certification_date": "2026-08-05",
        "status": "A",
        "authorized_official_last_name": "BOON",
        "authorized_official_first_name": "ERIC",
        "authorized_official_title_or_position": "AUTHORIZED OFFICIAL  / OFFICER",
        "authorized_official_telephone_number": "480-567-0259"
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://esmd.abilitynetwork.com:8291/gateway/documentsubmission/2_0/NhinService/XDRRequest_Service",
            "affiliation": "Y",
            "endpointDescription": "2.16.840.1.113883.3.667.2",
            "affiliationName": "Ability Network",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "CMS esMD eMDR",
            "address_1": "100 N 6th St Ste 900A",
            "city": "Minneapolis",
            "state": "MN",
            "country_code": "US",
            "postal_code": "554031516",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "ENDOSCOPY CENTER OF SOUTH SACRAMENTO",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Jefferson Arnaldo Encarnacion Garcia, DDS
• John Encinas
• Lena Marisol Encinas
• Mark E. Endicott, M.D.
• Mark Makoto Endo, D.D.S.
• Chioma Enemuoh, PHARMD
• Danny Jordan Enepekides, MD
• Bill Wun Eng, MD
• Engage Select Health & Recovery Solutions LLC
• Tess Engel

• Ambulatory Surgical Clinic/Center in Sacramento, CA
• Providers in Sacramento, CA by specialty
• Ambulatory Surgical Clinic/Center in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 5, 2026; 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.