Gi ASC LLC

Primary specialty

Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X

License

06181500 Issued in PA

Legal business name

GI ASC LLC

Practice address

3998 Red Lion Rd
Suite 240 - Cancer Center
Philadelphia, PA 19114-1436

Phone

(215) 632-3500

Fax

(215) 632-6533

NPI assigned

Apr 10, 2006

Last updated

Sep 6, 2012By 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

Elyse Carrullo

Title

Administrator

Phone

(610) 664-9700

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in PA

Enrollment records 1

Listed as

Gi ASC LLCCCN 39C0001067

Medicare certification status

ActiveFrom the Provider of Services file

Locations

Practitioners 5

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.

• Raynard J Cheung, M.D.

  • Gastroenterology Physician
  • Bala Cynwyd, PA
  • NPI 1891758843
  NPD (past)
• Matthew S. Cohen, M.D.

  • Gastroenterology Physician
  • Philadelphia, PA
  • NPI 1558304014
  NPD (past)
• Jeffrey M. Pilchman, M.D.

  • Gastroenterology Physician
  • Bala Cynwyd, PA
  • NPI 1942263017
  NPD (past)
• Anthony L Rosa, M.D.

  • Gastroenterology Physician
  • Bala Cynwyd, PA
  • NPI 1245294941
  NPD (past)
• Gregory D Schapiro, M.D.

  • Gastroenterology Physician
  • Bala Cynwyd, PA
  • NPI 1619931383
  NPD (past)

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

{
    "created_epoch": "1144627200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1346889600000",
    "number": "1649233719",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10 PRESIDENTIAL BLVD",
            "address_2": "SUITE 124",
            "city": "BALA CYNWYD",
            "state": "PA",
            "postal_code": "190041107",
            "telephone_number": "610-664-9700",
            "fax_number": "610-664-6391"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3998 RED LION RD",
            "address_2": "SUITE 240 - CANCER CENTER",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191141436",
            "telephone_number": "215-632-3500",
            "fax_number": "215-632-6533"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GI ASC LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-04-10",
        "last_updated": "2012-09-06",
        "status": "A",
        "authorized_official_last_name": "CARRULLO",
        "authorized_official_first_name": "ELYSE",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "610-664-9700"
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": "PA",
            "license": "06181500",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1013216400001",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Debolina Ghosh
• Ritam Ghosh, MD
• Rohan Ghosh, DO
• Suresh Chandra Ghosh, MD
• GHRS LLC
• Ann-Johanna Giaccone, M.D.
• Lisa Giacometti
• Michelle Giacometti, RD, LDN
• Albert A Giagnacova III, DPM
• Alec Michael Giakas, MD

• Ambulatory Surgical Clinic/Center in Philadelphia, PA
• Providers in Philadelphia, PA by specialty
• Ambulatory Surgical Clinic/Center in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 6, 2012; 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.