NPIMap

Organization Active NPI

Monterey Bay Endoscopy Center LLC

  • Ambulatory Surgical Clinic/Center
  • Monterey, CA
National Provider Identifier
1508818634
Registry record updated Mar 27, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X
License
070000315 Issued in CA
Legal business name
MONTEREY BAY ENDOSCOPY CENTER LLC
Practice address
23 Upper Ragsdale Dr
Suite 100
Monterey, CA 93940-7849
Phone
(831) 375-3577
Fax
(831) 375-1478
NPI assigned
May 17, 2006
Last updated
Mar 27, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 27, 2023

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

Authorized official

Name
Suzanne J Green
Title
Administrator
Phone
(831) 375-3577

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ambulatory Surgical Clinic/Center 261QA1903X 070000315 CA Primary

Addresses

Primary practice location

23 Upper Ragsdale Dr
Suite 100
Monterey, CA 93940-7849

Mailing address

23 Upper Ragsdale Dr
Suite 100
Monterey, CA 93940-7849
Phone (831) 375-3577

Other practice location 1

212 San Jose St Ste 100
Salinas, CA 93901-3928
Phone (831) 375-3577

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20041201000712 CA Part B Supplier - Ambulatory Surgical Center 6608831094 Practice locations: Monterey, CA
O20230710002415 CA Part B Supplier - Ambulatory Surgical Center 6608831094 Practice locations: Salinas, CA

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1508818634. Details of each certification follow.

Ambulatory surgical center certification: CCN 55C0001136

Name & address match This certification has no NPI in the Medicare enrollment files. CMS publishes enrollment files for six facility types only, so it was connected to this NPI by matching the name and address CMS publishes for it.

Legal name
Monterey Bay Endoscopy Center, LLC
Certification status
Active
Provider type (POS)
Ambulatory surgical center
Participating since
Jun 2, 2023
Last certification
Jun 6, 2023
Ownership / control type
Proprietary
Facility address
212 San Jose Street, Suite 100
Salinas, CA 93901

Care Compare: Ambulatory surgical center

Medicare Care Compare
Listed as
Monterey Bay Endoscopy Center LLCCCN 05C0001214
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
05D0590712Monterey Bay Endoscopy Center23 Upper Ragsdale Drive, Suite 100, Monterey, CA 93940Certificate of waiverFeb 25, 2028

National Provider Directory

National Provider Directory

Member of 2

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

Locations

23 Upper Ragsdale Dr
Monterey, CA 93940

212 San Jose St
Ste 100
Salinas, CA 93901

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": "1147824000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1679875200000",
    "number": "1508818634",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "23 UPPER RAGSDALE DR",
            "address_2": "SUITE 100",
            "city": "MONTEREY",
            "state": "CA",
            "postal_code": "939407849",
            "telephone_number": "831-375-3577",
            "fax_number": "831-375-1478"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "23 UPPER RAGSDALE DR",
            "address_2": "SUITE 100",
            "city": "MONTEREY",
            "state": "CA",
            "postal_code": "939407849",
            "telephone_number": "831-375-3577",
            "fax_number": "831-375-1478"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "212 San Jose St Ste 100",
            "address_purpose": "LOCATION",
            "city": "Salinas",
            "state": "CA",
            "postal_code": "939013928",
            "country_code": "US",
            "telephone_number": "831-375-3577",
            "fax_number": "831-375-1478",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "MONTEREY BAY ENDOSCOPY CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-17",
        "last_updated": "2023-03-27",
        "certification_date": "2023-03-27",
        "status": "A",
        "authorized_official_last_name": "GREEN",
        "authorized_official_first_name": "SUZANNE",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "831-375-3577"
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": "CA",
            "license": "070000315",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Monterey, CA

Sources for this page

Verify at the official NPI Registry.