Endo Group, LLC

Primary specialty

Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X

License

2905200R Issued in NY

Legal business name

ENDO GROUP, LLC

Doing business as

Garden City SurgiCenter

Practice address

400 Endo Blvd
Garden City, NY 11530

Phone

(516) 832-8504

Fax

(516) 832-1085

NPI assigned

Sep 29, 2006

Organization subpart

No

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

Authorized official

Name

Ms. Kelly Fitzpatrick

Title

Administrator

Phone

(516) 832-8504

Specialties & licenses 1

Addresses

Other identifiers 7

Other names 1

• Garden City SurgiCenter Doing business as

Medicare fee-for-service enrollment

Enrolled in NY

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).

• Endo Group, LLC

  • Ambulatory Surgical Clinic/Center
  • Syosset, NY
  • NPI 1598328932

  0446356844

  Same PAC ID

Listed as

Endo Group LLC Dba Garden City SurgicenterCCN 33C0001007

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

Endo Group LLC2 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.

• Endo Group, LLC

  • Ambulatory Surgical Clinic/Center
  • Syosset, NY
  • NPI 1598328932
  NPD tax ID

Subparts reporting this organization as parent 1

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

• Endo Group, LLC

  • Ambulatory Surgical Clinic/Center
  • Syosset, NY
  • NPI 1598328932
  NPPES parent name

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

{
    "created_epoch": "1159488000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1443744000000",
    "number": "1639261407",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 ENDO BLVD",
            "city": "GARDEN CITY",
            "state": "NY",
            "postal_code": "11530",
            "telephone_number": "516-832-8504",
            "fax_number": "516-832-1085"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 ENDO BLVD",
            "city": "GARDEN CITY",
            "state": "NY",
            "postal_code": "11530",
            "telephone_number": "516-832-8504",
            "fax_number": "516-832-1085"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ENDO GROUP, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-29",
        "last_updated": "2015-10-02",
        "status": "A",
        "authorized_official_last_name": "FITZPATRICK",
        "authorized_official_first_name": "KELLY",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "516-832-8504",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": "NY",
            "license": "2905200R",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HIP PROVIDER ID",
            "identifier": "331007",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA PROVIDER ID",
            "identifier": "14404",
            "state": "NY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01088980",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTHNET PROVIDER ID",
            "identifier": "IC0199",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "EMPIRE BCBS PROVIDER ID",
            "identifier": "003602",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "33C0001007",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OXFORD PROVIDER ID",
            "identifier": "A382712",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Garden City SurgiCenter",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Denise L Emma, DDS
• Shammi Emmanuel, PA
• Emmett E Campbell MD PC
• Empire Physical and Occupational Therapy
• Empire Vision Center Inc
• Jennifer Marie Endo, AGPCNP-BC
• Endoscopy Center of Long Island LLC
• Endoscopy Center of Long Island LLC
• Kathleen Mary Englehardt, DDS
• Rena English, LMSW

• Ambulatory Surgical Clinic/Center in Garden City, NY
• Providers in Garden City, NY by specialty
• Ambulatory Surgical Clinic/Center in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 2, 2015; 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.