San Luis Obispo Ca Endoscopy ASC LP

Primary specialty

Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X

License

050000424 Issued in CA

Legal business name

SAN LUIS OBISPO CA ENDOSCOPY ASC LP

Doing business as

Endoscopy Center of the Central Coast

Practice address

77 Casa St
Suite 106
San Luis Obispo, CA 93405-5803

Phone

(805) 541-1021

Fax

(805) 541-3142

NPI assigned

Feb 20, 2006

Last updated

Jun 22, 2022By 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

Mr. Jeffrey Snodgrass

Title

President

Phone

(615) 665-1283

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• Endoscopy Center of the Central Coast Doing business as

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Other NPIs with the same Medicare PAC ID 1

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

• San Luis Obispo Ca Endoscopy ASC LP

  dba Templeton Endoscopy Center

  • Ambulatory Surgical Clinic/Center
  • Templeton, CA
  • NPI 1184699241

  7911936307

  Same PAC ID

Listed as

Endoscopy Center of the Central CoastCCN 05C0001318

Medicare certification status

ActiveFrom the Provider of Services file

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

CLIA laboratory certificates

Tax ID family

San Luis Obispo Ca Endoscopy ASC LP2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• San Luis Obispo Ca Endoscopy ASC LP

  dba Templeton Endoscopy Center

  • Ambulatory Surgical Clinic/Center
  • Templeton, CA
  • NPI 1184699241
  NPD tax ID

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

{
    "created_epoch": "1140393600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1655856000000",
    "number": "1487629986",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "77 CASA ST",
            "address_2": "SUITE 106",
            "city": "SAN LUIS OBISPO",
            "state": "CA",
            "postal_code": "934055803",
            "telephone_number": "805-541-1021",
            "fax_number": "805-541-3142"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "77 CASA ST",
            "address_2": "SUITE 106",
            "city": "SAN LUIS OBISPO",
            "state": "CA",
            "postal_code": "934055803",
            "telephone_number": "805-541-1021",
            "fax_number": "805-541-3142"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SAN LUIS OBISPO CA ENDOSCOPY ASC LP",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-02-20",
        "last_updated": "2022-06-22",
        "certification_date": "2022-06-22",
        "status": "A",
        "authorized_official_last_name": "SNODGRASS",
        "authorized_official_first_name": "JEFFREY",
        "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": "050000424",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD",
            "identifier": "P00638978",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "SUR01318F",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Endoscopy Center of the Central Coast",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Endoscopy Center of the Central Coast",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• San Luis Imaging Medical Group, Inc
• San Luis Internal Medicine Associates, a Medical Corporation
• San Luis Obispo
• San Luis Obispo Behavioral Health
• San Luis Obispo Behavioral Health
• San Luis Obispo Campus Health
• San Luis Obispo Center for Change
• San Luis Obispo Child Development Center
• San Luis Obispo County
• San Luis Obispo County AIDS Support Network

• Ambulatory Surgical Clinic/Center in San Luis Obispo, CA
• Providers in San Luis Obispo, 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 Jun 22, 2022; 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.